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. 2024 Aug;60(6):1081-1093.
doi: 10.1007/s10597-024-01260-z. Epub 2024 Mar 22.

Examining Youth Flexible ACT Model Implementation in the Netherlands

Marieke Broersen  1   2 , Nynke Frieswijk  3 , Maaike van Vugt  4 , Ad A Vermulst  5 , Daan H M Creemers  5 , Hans Kroon  6   4
Affiliations

Examining Youth Flexible ACT Model Implementation in the Netherlands

Marieke Broersen et al. Community Ment Health J. 2024 Aug.

Abstract

Model adherence is a key indicator of mental health care quality. This study investigates the degree of model adherence, as well as content and staging of care, among the first Youth Flexible Assertive Community Treatment (ACT) teams in the Netherlands. Model fidelity was assessed in sixteen teams with the Youth Flexile ACT model fidelity scale (2014 version). Mental health workers completed a 'content of care questionnaire' to map the interventions applied in the teams. Model fidelity scores revealed that twelve teams adhered to the Youth Flexible ACT standard with 'optimal implementation' (≥ 4.1 on a 5 point scale) and four teams with 'adequate implementation'. Most disciplines were well integrated within the teams; however, several items regarding the involvement of specific disciplines and the availability of treatment interventions (peer support worker, employment and education specialist and programs, family interventions, integrated dual disorder treatment) scored below the optimum. Frequency of contact during ACT and the use of Routine Outcome Monitoring instruments scored below the optimum as well. The 'content of care' data showed that most clients received an individual psychological intervention, and nearly half of the client sample received scaled-up / intensified ACT care. The findings indicate a predominantly successful translation of care from the theoretical Flexible ACT framework into practice, covering both ACT and non-ACT functions. Further room for improvement lies in the incorporation of specialized disciplines in the personal and social recovery domains, including the peer support worker and employment and education specialist, as well as in specific protocolled interventions.

Keywords: Adolescent Mental Health; Flexible Assertive Community Treatment; Integrated Care Approach; Model fidelity.

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Conflict of interest statement

Prof. Dr. Kroon is a board member of the Centre for Certification ACT and Flexible ACT (CCAF) and a board member of FACT Netherlands. Dr. Maaike van Vugt is an advisor for the CCAF and a member of the CCAF Quality Committee. The CCAF executes peer audits using model fidelity scales to ensure the quality of ACT and Flexible ACT. Dr. Frieswijk chairs the national platform Youth Flexible ACT and is a member of the board of FACT Netherlands. MSc. Broersen, Dr. Creemers, and Dr. Vermulst receive a salary from GGZ Oost Brabant. All opinions presented in this manuscript belong to the authors alone. The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Total Model Fidelity Scores of the 16 Youth Flexible ACT Teams
See this image and copyright information in PMC

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