Yale University School of Medicine, New Haven, CT 06112, USA.
J Am Psychiatr Nurses Assoc. 2011 Jan-Feb;17(1):45-50. doi: 10.1177/1078390310393509.
Assertive Community Treatment (ACT) has been studied extensively in people with severe mental illness, but there have only been a few clinical trials in which substance use was one of the measured outcomes.
The goal of this article was to describe the efficacy of ACT in treating co-occurring substance use disorders and suggest approaches to make it more efficacious.
A literature review was conducted and randomized clinical trials describing ACT's impact on substance use were reviewed.
Four randomized clinical trials of ACT that measured substance abuse adequately were identified, all of which showed small to no effect on substance abuse compared with control conditions. Methodological issues might account for the small effects. ACT might further reduce substance use by being paired with evidenced-based substance abuse treatment, helping clients become housed or helping them manage their money better.
Integrated ACT, in which the ACT team provides substance abuse counseling, has the potential to reduce substance use by several mechanisms, but this has been difficult to demonstrate in clinical trials when participants in control groups receive similar interventions.
决断性社区治疗（ACT）在严重精神疾病患者中已经进行了广泛的研究，但只有少数临床试验将物质使用作为衡量结果之一。
本文的目的是描述 ACT 在治疗共病物质使用障碍方面的疗效，并提出使其更有效的方法。
进行了文献回顾，并对描述 ACT 对物质使用影响的随机临床试验进行了回顾。
确定了四项充分衡量物质滥用的 ACT 随机临床试验，与对照条件相比，所有这些试验对物质滥用的影响都很小或没有。方法学问题可能是造成小效应的原因。ACT 可以通过与循证物质滥用治疗相结合、帮助客户获得住房或帮助他们更好地管理自己的钱来进一步减少物质使用。
综合 ACT，即 ACT 团队提供物质滥用咨询，有可能通过多种机制减少物质使用，但当对照组的参与者接受类似的干预时，在临床试验中很难证明这一点。
