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This study tested the hypothesis that assertive and nonassertive people have different personality profiles and self-actualizing values. Results indicated that assertive and nonassertive groups differed significantly, in terms of their personality profiles based on the Personality Research Form, and their self-actualization profiles based on the Personal Orientation Inventory, supporting the tested hypothesis.
The purpose of this study was to develop and apply an experimental approach for teaching assertive behaviors in selective problematic interpersonal situations encountered by homosexuals. Specifically, the approach explicates a treatment format that combines the use of stimulus/modeling videotapes with behavioral rehearsals, videotape feedback, and home assignments. Results of a single-subject interrupted time-series analysis suggest that the client displayed significantly more assertive behaviors on four of the six criterion measures. The findings further suggest that with contextual modification this interventive format can be applied to a variety of sexual behavior patterns.
Six men alcoholics showed increased assertiveness and improvement in social and occupational status after attending a group assertiveness training program.
Alcoholics who recieved 10 hours of assertiveness training scored significantly higher than control and minimal training groups on three measures of assertiveness.
A total of 447 Israeli students, both males and females, from four educational institutions were administered the College Self-expression Scale, a measure of assertiveness. The obtained responses were factor analyzed using the principal axis solution and the varimax rotation method. The results showed four main factors which included 43 of the 50 items of the original scale. These factors were identified as the willingness to take risks in interpersonal interactions, the ability to communicate feelings, setting rules and rectifying injustices, and the presence or absence of a tendency to invoke a self-punitive attitude. The findings were interpreted as adding support to the validity of the scale as a measure of assertiveness.
Assertive and intensive community treatment for the seriously mentally ill is becoming a widely accepted approach internationally. This type of service is, however, still relatively new in Australia and New Zealand, and it has rarely been fully integrated into a comprehensive catchment area community and hospital mental health service. This paper has two aims. Firstly, it describes an innovative assertive community mental health service in suburban Sydney. This service was initially provided to 64 clients with a serious mental illness, who had previously experienced repeated hospitalisations and were unable to benefit from existing high quality services. Secondly, it presents the results of the ongoing evaluation of this service. Following the implementation of the service, the number of psychiatric bed days occupied by these clients decreased by 62%; the number of clients admitted decreased, client functioning improved and symptom severity decreased, all to a significant degree.
PURPOSE: The purpose of the study was to examine daily time use of clients of Assertive Community Treatment (ACT) as a measure of their community adjustment and well-being. The actual daily time use of ACT clients in the four categories of personal care, productivity, leisure, and sleep were compared to the data for Canadian population norms. METHOD: Daily time use data were collected from 27 adult clients from two Assertive Community Treatment Teams in southeastern Ontario using recall time diaries of two weekdays. The data were coded using the Statistics Canada (1999) coding scheme. Descriptive statistics were used to determine time in the major categories of time use and z scores were used to compare the study sample to the adult Canadian population. The percentages of time spent in specific subcategories of activity were also compared. RESULTS: The results indicated an imbalance in occupation with time use dominated by leisure and sleep activities. Study participants spent significantly more time in passive leisure compared to active leisure and socialization. CONCLUSION: The activity patterns of ACT clients were not consistent with those associated with community adjustment, health, and well-being. Occupational therapists working in ACT are in a good position to contribute to the literature regarding occupational performance and mental illness and to lead ACT teams in discussions and practices that may promote health through activity.
This article discusses economic considerations associated with evidence-based practices for people with severe mental illness that involve grouping treatment and rehabilitation staff into a single team. The article includes a brief review of the evidence and arguments that both assertive community treatment and supported employment are effective in promoting recovery, as well as having other favourable outcomes. In terms of cost, assertive community treatment appears to allow flexible deployment of resources such that the number of days in hospital is reduced, which means that in many cases this form of treatment pays for itself. Evidence for a similar cost offset with supported employment is much more limited. Even when such practices increase overall costs, they appear to be more cost-effective than the alternatives with which they have been compared. Consideration of these findings together suggests that improved synthesis and use of individual-level clinical information, which are more easily achieved by a team, are key to more cost-effective service delivery for people who need the expertise of different kinds of professionals.
Asserting Bologna Declaration into university education is a long-term and challenging process. New features have to be asserted sensitively in order to develop school system and to strengthen the baseline for Declaration. Slovakia has started the restructuring of university system and study programs undergoing the process of accreditation, however marked support (or reform) for covering the costs of university education is missing (expressed as % of gross domestic product, Slovakia is still not comparable to other EU countries). At present, not satisfactory economic conditions prevent from reaching the content, personal and equipment preconditions at universities (Ref. 7).
Case reports and chart reviews of patients asserting environmental illness suggest that they suffer from psychiatric difficulties, typically somatization disorder. We assert that viewing these patients solely as somatizers or hysterical characters searching for a nurturant relationship will undermine the doctor-patient relationship. Rather, many of these patients are obsessive/paranoid characters searching for a medical explanation to their physical symptoms. This distinction is highlighted by contrasting the clinical presentations of hysteric/somatizing patients with those environmental illness patients demonstrating an obsessive/paranoid style. Further illustration is provided by a case report with psychological test data. Finally, treatment recommendations based upon this distinction are delineated.
Nurses in upper- and middle-management positions often struggle with issues related to assertiveness. The author lists some questions that nursing administrators and managers have raised at assertiveness workshops and offers some answers.
Lack of assertiveness is considered, in the sense of the theoretical concept of Ullrich de Muynck and Ullrich, to be due to such components as 1. abnormal attitude toward oneself, 2. fear of criticism and failure, and 3. inadequately developed social skills; after this, the term 'assertiveness' is defined. Previous therapeutical approaches to the remedying of unassertiveness and the underlying theoretical assumptions are critically examined and discussed with particular reference to their effectiveness. These include the training programs developed by Salter and Wolpe which are characterized by certain onesidedness as well as the concept of Ullrich de Muynck and Ullrich, which has a sound theoretical basis and a rather differentiated or specialized structure. Reference is also made to the author's own research projects.
Among 652 Swedish and 654 Turkish adolescents, the study found that 61 Swedish (9.4%) and 71 Turkish (10.9%) adolescents reported that they had made previous suicide attempts. Previous psychiatric contact, female gender, low perceived family support, and suicide attempts in the family for the Swedish group and suicide attempts in the family, low perceived family support, psychiatric disorder in the family, and previous psychiatric contact variables in the Turkish sample were found to be associated with previous attempts. Low perceived family support, previous suicide attempts, low perceived peer support, female gender, previous psychiatric contact, low positive assertion skills, and a small number of friends for the Swedish; and low perceived family support, previous suicide attempts, low perceived peer support, suicide attempts in the family, and previous psychiatric contact variables for the Turkish group were found to be significant predictors of current suicidal risk.
Fifty-three self-defined compulsive eaters recruited from weight loss programs and a college population and prescreened to eliminate probable anorexics and bulimics participated in this study. They completed the Three Factor Eating Questionnaire, Beck Depression Inventory, Compulsive Eating Scale, Eating Obsessive-Compulsive Questionnaire, Personal Assertion Analysis, and provided demographic information. Participants had high scores for compulsive eating and disinhibition and low scores for depression. The best predictors of compulsive eating were disinhibition and obsessive thoughts of food, which accounted for 61% of the variance. Twenty-one percent of the sample reported a history of sexual abuse. Thirty-one percent of the sample were classified as medically obese, yet 49% perceived themselves to be moderately to very overweight.
BACKGROUND: People with severe mental illness and substance use disorders (dual disorder) often have considerable contact with the criminal justice system. AIMS: To test the effects of client characteristics on six criminal justice outcomes among homeless (at intake) people with mental illness and substance misuse disorders. METHODS: The sample was of participants in a randomized controlled trial comparing standard treatment, assertive community treatment (ACT) and integrated treatment (IT). Data were analysed using hierarchical logistic regression. RESULTS: Half the sample was arrested and a quarter incarcerated during the two-year follow-up period. The regression models explained between 22% and 35% of the variance of the following criminal justice measures: (1) major offences, (2) minor offences, (3) substance-use-related offences, (4) incarcerations, (5) arrests, and (6) summons. Prior criminal behaviour was the strongest predictor of all of the dependent variables; in general, demographic and diagnostic variables were not. Similarly, neither the type nor the amount of mental health treatment received predicted subsequent criminal behaviour. CONCLUSION: Elsewhere the authors have shown that ACT and IT had advantages for health and stability of accommodation but these analyses suggest that more specialized interventions are needed to reduce criminal behaviour in dual disorder individuals.
Evaluated a large-city adaptation of the assertive community treatment (ACT) model (Stein & Test, 1980). Outcomes were examined after 1 year for 82 clients, averaging over 17 lifetime psychiatric hospitalizations, randomly assigned either to ACT or to a drop-in (DI) center. After 1 year, 76% of the ACT clients and only 7% of DI clients were involved in the respective programs. The ACT team averaged 2 home and community visits per week to each client. ACT clients averaged significantly fewer state hospital admissions and state hospital days than did DI clients. ACT clients reported greater satisfaction with program services, fewer contacts with the police, and less difficulty with practical problems associated with psychiatric readmission. More ACT clients were known to have stable community housing. Annual per-client treatment costs for ACT were estimated to be $1,500 less than for DI.
Discusses historical, policy, and research perspectives on assertive community treatment (ACT) and their relationship to 5 commentaries accompanying our recent article (Bond et al., 1990). Collectively, the commentaries focused on self-help groups, missing the point of the study. Further, the commentaries contained several misconceptions centering on a confusion between deliberate sampling based on policy-driven considerations and self-selection into voluntary organizations. In the time since the Stein and Test (1980) demonstration, programs based on ACT principles have become one of the dominant approaches to community mental health services, especially for consumers who do not readily use office-based treatment. The research foundation is robust and is rapidly evolving. Some community psychologists may be responding to outdated and inaccurate stereotypes of mental health services.
Twenty experts on assertive community treatment (ACT) rated the importance of 73 program elements, also indicating ideal model specifications (e.g., minimum time commitment for psychiatrist) when appropriate. Interexpert agreement on ratings of importance was high (intraclass r = .94), although there was less agreement for some areas--for example, team structure (intraclass r = .70). Survey responses suggested several areas of increasing emphasis (e.g., vocational and addictions specialists) and of decreasing emphasis (e.g., the avoidance of office visits). Two subgroups of experts were identified--those who advocated large multidisciplinary teams (100 or more clients) and day and evening shifts, and those who advocated smaller, often generalist, teams (approximately 50 clients). Experts also reported ideal staffing for an ACT team. The most frequently identified disciplines were psychiatrist, nurse, and social worker. Implications for mental health policy--for example, quality assurance and program standards--are discussed.