Does Assertive Community Treatment Work with Forensic Populations? Review and Recommendations

ABSTRACT

Several variations of the Assertive Community Treatment model have been tried with forensic and offender populations, including Forensic Assertive Community Treatment (FACT), Forensic Intensive Case Management (FICM) and Integrated Dual Diagnosis Treatment (IDDT). Based on a comprehensive review of multiple reviews and research studies, it appears that the field is converging on the conclusion that ACT may have a positive impact on mental health for forensic patients, but that it is probably ineffective or minimally effective in reducing criminal recidivism. The author argues that emerging research from the “forensic continuum of care model” and correctional re-entry treatment programs suggests that the community aftercare component is vital with offending populations and that aftercare programs like ACT can be enhanced by a “pre-treatment” residential treatment precursor. Specifically, the provision of enriched or extended residential treatment – in which forensic patients have adequate time to learn, practice and master life management skills – can maximize the effectiveness of follow-up ACT. Most FACT and FICM approaches have lacked this “continuum” feature.