Neijmeijer, Laura J., Didden, Robert, Nijman, Henk L. I., and Kroon, Hans
Subjects
MENTAL illness treatment, PEOPLE with intellectual disabilities, ATTITUDE (Psychology), COMMUNITY health services, HEALTH facilities, MEDICAL personnel, HEALTH policy, MEDICAL practice, SOCIAL support, HUMAN services programs, SEVERITY of illness index, THERAPEUTICS
Abstract
Individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF) and mental health problems or challenging behavior are difficult to reach by mainstream healthcare facilities and support organizations and frequently avoid the care they need. To improve the care for this client group in the Netherlands, the (Flexible) Assertive Community Treatment (ACT) model—originally developed for people with severe mental illness—was adapted and implemented by five organizations specialized in the care for people with MID/BIF and mental health problems or challenging behavior. After an introduction of the original ACT model and a description of the international state of the art of ACT for people with (M)ID/BIF, this paper describes the (Flexible) ACT‐MID/BIF model as developed and implemented in the Netherlands. Professionals' and clients' experiences with this new type of care are reported as well. Implications for clinical practice, policy and research are discussed. [ABSTRACT FROM AUTHOR]
Neimeijer, E. G., Roest, J. J., Helm, G. H. P., and Didden, R.
Subjects
FACTOR analysis, PEOPLE with intellectual disabilities, PSYCHOMETRICS, RESEARCH evaluation, DISABILITIES, RESIDENTIAL care, PSYCHIATRIC treatment, MULTITRAIT multimethod techniques, RESEARCH methodology evaluation, INTRACLASS correlation, THERAPEUTICS
Abstract
Background: This study examined the psychometric properties of the Group Climate Instrument (GCI) in a sample of N = 189 adults (79% men) with mild intellectual disability or borderline intellectual functioning who were residents of a treatment facility in the Netherlands. Method: Construct validity of the GCI was examined by means of confirmatory factor analysis. Also, reliability and convergent validity of the GCI were examined. We also examined the variability in perception of the living group climate between and within living groups by computing intraclass correlation coefficients. Results: The model contained four first‐order factors (support, growth, group atmosphere and repression) and a second‐order factor overall climate, providing preliminary support for construct validity of the GCI. Reliability coefficients were good for all factors. Preliminary evidence for convergent validity was found in significant moderate associations between subscales and single item ratings for the factors of group climate. The intraclass correlation coefficients indicated that a considerate proportion of variance can be attributed to between‐group differences. Conclusions: The GCI might be used to assess perception of the living group climate for individuals with mild intellectual disability or borderline intellectual functioning in psychiatric and forensic care settings, although further development of the GCI and replication of our findings seem necessary. [ABSTRACT FROM AUTHOR]