Assertive Engagement - UNC Center for Excellence in Community Mental Health

Assertive Community Treatment (ACT) is a least-restrictive treatment alternative directed at individuals who, without ACT, may find themselves in much more restrictive circumstances due to their illness. Individuals are not discharged from the program for missing appointments or not participating in treatment.

The level of engagement and motivation to receive services varies across individuals, with reasons for poor engagement ranging from factors inherent to their illness (e.g., lack of insight) to a rational reaction to a service system experienced negatively. Retention is a high priority for ACT teams, as the team cannot effectively support a person in keeping an apartment, securing employment, or mending relationships if that person is not enrolled in services. Persistent, caring outreach helps foster a trusting relationship between the individual and the ACT team.

Therapeutic limit-setting interventions may be necessary when collaborative approaches fail or risks are too high. When used, these interventions are gradually titrated down in favor of more collaborative approaches that promote empowerment and autonomy.

Learn more about assertive engagement within ACT, including the use of motivational interventions and therapeutic limit-setting techniques, through the resources below.