the team leader in assertive community treatment

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Objectives. Know the importance of team work in delivery of ACT servicesKnow the ACT team leader qualities and qualifications Know the roles and responsibilities of an ACT team leader to facilitate hiring and supervision of this person. Responsibilities of agency leadership when developing ACT . Need to understand paradigm shift with ACT Need to recognize the importance of teamwork in service deliveryNeed to identify and hire the right team leader.

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the team leader in assertive community treatment

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1. The Team Leader in Assertive Community Treatment Lynette Studer, MSSW Team Leader, Green County, Wisconsin Susan Boust, MD ACT Team Psychiatrist, Omaha, Nebraska

3. Responsibilities of agency leadership when developing ACT Need to understand paradigm shift with ACT Need to recognize the importance of teamwork in service delivery Need to identify and hire the right team leader

4. ACT and the Concept of Team One of the critical ingredients of ACT is a multidisciplinary team Team Work is necessary for psychiatric care inpatient, residential, day rehab, etc. ACT is the only model providing case management that requires teamwork

5. Beliefs about teams Good teamwork translates into improved patient care Strong leadership leads to better team work Communication and organizational tools are important to good team work Knowledge of teamwork and leadership has been developed in business more than social services There are stages of team development

6. ACT and the importance of the multidisciplinary team In most cases, the knowledge of a group leads to better decisions than those made by individuals There is peer pressure to follow through with assigned tasks It is less disruptive to the client because there is a circle of workers they know There is collective pride in ownership of decisions and work There are more resources that are “ready to go” in a time of need Teamwork avoids dependency problems

7. Pitfalls of team delivery of services Takes more time for communication Potential to send inconsistent messages to the client Potential for worse accountability Requires focus on good organization Dependent on strong leadership

8. What variables contribute to a well functioning ACT team? Multidisciplinary Shared vision Clear role for Team Leader Mutual trust Adequate resources for the team Supportive administrative structure over the team Time for communication and processing Good organization tools Good communication tools

9. The Critical Factor - Hire the Right Team Leader

10. Hire the right Team Leader Do hire good clinician leadership skills management skills Well, of course. Sounds simple!

11. Good Clinician Knowledge of illness and treatment know the population clinical competencies credentials - at least master’s degree in social work, psychology, nursing Clinical judgment ability to assess and analyze a clinical situation quickly ability to direct service delivery in a timely manner ability to assess the adequacy of the current treatment plan and timeliness in changing plans Community-based treatment and rehabilitation philosophy embrace recovery principles and implement them into practice model respectful communication and relationship skills with clients to maximize the therapeutic alliance Models complete and well-written documentation understand the importance of the treatment plan, progress notes, etc. as a communication tool and service delivery support awareness of legal aspects of care

12. Good Leadership Skills Sets and maintains the team vision - where are we going? Takes calculated risks- makes judicious decisions that are solution focused Optimistic, can do attitude with an awareness of resources, inspiration, charisma Holds concept of client first, team second, staff member third Knowledge of team work Moral character, integrity, trustworthy Has emotional stability; doesn’t personalize information; mature Flexibility, tolerance of ambiguity and appropriate empowerment of staff Respectful and practices with humility, openness to learning and views mistakes as opportunities for growth Demonstrates direct and assertive communication

13. Good Managerial Skills Holding staff accountable for treatment clinical and administrative supervision and performance feedback across all disciplines Good communication skills Hiring and training staff Resource management and how that “fits” into bigger picture Organized at macro and micro levels attentive to details efficiency and optimal use of resources ability to multi-task Organize and lead productive team meetings

14. Summary of who to hire as an ACT Team Leader Do hire good: clinical skills leadership skills management skills Don’t hire a clinician with no community-based treatment experience someone who does not embrace a recovery and rehabilitation philosophy pessimistic person arrogant person can’t model teamwork

15. We’re looking for a good team leader Successful applicant must be an excellent clinician with at least a master’s degree in social work, psychology or nursing. Prior experience and success in providing community-based services to persons with serious mental illness is necessary. People with experience working in a community team environment are given preference. It is essential that you respect and enjoy working with people who suffer from serious mental illness, that you believe in their ability to learn to manage their own lives and live in the community, and that you model respectful communication when working with them and their families. Exceptional leadership and managerial skills are a must. Hours include weekends, evenings as well as some holidays and on call. A joy in working with people is helpful. People with a pessimistic or arrogant personality need not apply.

16. Team Leader Role In currently available ACT manuals and literature, there is little written information clarifying the role of team leader The role of the team leader clearly includes supervision of the team as well as direct clinical practice For new teams, the Team Leader also has the role of program developer

17. Team Leader Role

18. Team Leader/ Psychiatrist roles ACT team function requires collaboration and cooperation between the team leader and psychiatrist Policies will not replace joint agreement to respect each other, to work together for the best interest of the consumer, and to share clinical decision making In certain situations, consensus may not be reached in the time available, however a decision is still required. Either the team leader or psychiatrist must defer to the other’s decision for immediate implementation. In this situation, it is important to 1. Focus on the best for the consumer, 2. Agree to review the situation when more information or time is available, 3. Not personalize the conflict.

19. Team Leader Responsibilities The Team Leader is responsible for everything related to the team Responsible for everything done by the team, plus some activities that don’t involve the team The tasks of an ACT team are to provide treatment, rehabilitation and support to the clients

20. Team Leader Responsibilities Clinical oversight Direct clinical practice Team management Program operations Community Public Relations Interagency communication

21. Clinical Oversight Assure that the team provides competent and respectful treatment, rehabilitation and support to every ACT client, e.g., provide supervision during team meetings, individually, and in side-by-side assess and facilitate the training and development needs of team members Treatment plans are complete, individualized, based on consumer input, and drive the delivery of services

22. Direct Clinical Practice Screen potential admissions communicate with referring agencies interview and complete assessment of potential admissions Decide about admission with psychiatrist Develop a comprehensive assessment and treatment plan Carry a case load and see ACT clients on a routine basis

23. Team Management Team building Scheduling all team activities consistent staff contact schedule admissions Managing stages of team development Cross training disciplines Assuring shared staff roles Resolution of conflict Competent communication Operationalizing ACT tools

24. Program Operations resource management hiring, orientation, quality improvement and outcome assessment administrative requirements office space to paper clips staff travel, on call schedule chart management and compliance issues policy and procedure development monitoring and complying with state and agency regulations billing and program fund management

25. Community Public Relations Disseminate information about ACT services Community Education about mental illness Building relationships with referring agencies Participate with the agency in media and law enforcement relations

26. Intra-agency communication Primary contact person for communication Serve as the team’s representative to agency functions Serve on committees to foster intra-agency communication and collaboration Provide support for agency mission and vision Obtain supervision from agency leadership

27. What support does a team leader need? The administration of the parent agency must provide support to the ACT team, including: Sharing the vision of ACT-to implement and support a paradigm shift in thinking about mental health service delivery Having adequate resources to support the functioning of the team Helping the team leader navigate agency and state bureaucracy that may inhibit implementation Provide supervision to the ACT team leader

28. Team Leader Responsibilities Team Leaders are responsible for moving the team to accomplish its task. Team leaders should ensure an environment that helps teams get their work done. The team leader is responsible for obtaining these resources, and if they are unavailable then the team leader must inform the team of the situation and direct the team to consider other options.

29. In Summary ACT requires a multidisciplinary team with a strong team leader The Team Leader role is essential to the implementation of an ACT team The strongest candidates will have a balance of all three skill bases: clinical, leadership and managerial Team Leader responsibilities include: clinical oversight, direct clinical practice, team management, program operations, community public relations, and intra-agency communication

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