MODELS Flashcards
What is the brokerage model in community care?
A model where the main worker acts as a broker coordinating various services without actively providing input.
This model emphasizes service coordination rather than direct engagement.
What does the case management model emphasize?
Continuity of care, with a single professional responsible for long-term supportive care across all aspects.
This includes engagement, assessment, planning interventions, delivering them directly, and monitoring effectiveness.
What was the main issue evaluated by Stein & Test in 1980 regarding assertive community treatment (ACT)?
The transfer of learning in social skills training in real life when patients move from inpatient units to the community.
They noted that community care often led to a tenuous community adjustment.
What was the conclusion of the UK 700 study regarding ACT services?
Caseload is the most important predictor of outcome.
ACT is shown to reduce admissions, acute presentations at A&E, and increase compliance with secondary care.
What did the Cochrane review reveal about ACT compared to intensive community management?
No clear advantage could be demonstrated between ACT and intensive community management.
This indicates that both models may have similar effectiveness.
List the principles of the ACT model.
- Continuous service in time and functional continuity
- Staff ratio of 1 to 10-15 patients
- Most work done in the community
- Team involvement for each case
- Individualized treatments without time constraints
- Direct assistance and service delivery without commissioning
- Primary outcome is functional improvement
- Bulk care provided by the team
- Titrated input as needed
- Backing off service provision when patient refuses to engage
What is the focus of intensive case management?
It is proposed for hard-to-engage patients and follows ACT principles but with individual case loads.
The main drawback is heavy staff burnout and responsibility.
What is another name for the personal strengths model?
Development – acquisition model.
This model emphasizes the patient as the primary director of the process.
What does the personal strengths model acknowledge about the patient?
That the patient is able to grow and change inherently.
The therapeutic relationship is prioritized, and no goals are imposed on the patient.
How is the rehabilitation model similar to the personal strengths model?
Both are patient-directed processes but the rehabilitation model retains a deficit focus.
It also stresses increased patient autonomy and independence.
