Abstract
BackgroundIn this study, we aimed to identify and define the fundamental components of the working alliance in multidisciplinary (Flexible) Assertive Community Treatment teams with shared caseloads, in order to support their daily practice and further research.MethodsAfter reviewing the literature, concept mapping with professionals and clients was used to define the working alliance in (F) ACT teams. The resulting concept maps formed the basis for the working alliance assessment instrument, which was pilot tested with professionals and clients through cognitive interviews with a think-aloud procedure.ResultsThe study led to the development of a twenty five-item assessment instrument to evaluate working alliances in multidisciplinary teams (WAM) that was comprised of three subscales: bond, task/goal and team. Two different versions were developed for clients and professionals.ConclusionsThe WAM instrument was developed to determine the quality of the working alliance in (F) ACT teams. Future research will focus on testing its psychometric properties and predictive value.
Highlights
In recent years, the care of clients with severe mental illness (SMI) has increasingly moved from institutional to community settings
Flexible Assertive Community Treatment is a variant of Assertive Community Treatment and is the dominant model used for community mental health care for clients with SMI in the Netherlands
The hypothesis that arose from the literature search was that clients of outpatient, multidisciplinary teams with shared caseloads value certain aspects of the working alliance more than other aspects, and that this difference is both important and personal
Summary
The care of clients with severe mental illness (SMI) has increasingly moved from institutional to community settings. Several interventions have been developed to manage the care of clients with SMI in the community, including Assertive Community Treatment (ACT) and Flexible Assertive Community Treatment [1, 2] (FACT). Flexible Assertive Community Treatment is a variant of Assertive Community Treatment and is the dominant model used for community mental health care for clients with SMI in the Netherlands. FACT was developed because no effective treatment model existed for this group of clients with SMI. We aimed to identify and define the fundamental components of the working alliance in multidisciplinary (Flexible) Assertive Community Treatment teams with shared caseloads, in order to support their daily practice and further research
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