Table 1.
Studies examining consumer providers on ACT and case management teams.
| Citation | Sample/Power Adequacy | Service Setting | Peer Role | Supervision Description | Positive Outcome | Main Findings |
|---|---|---|---|---|---|---|
| Randomized Controlled Trials | ||||||
| (Clarke, et al., 2000) (Herinckx, Kinney, Clarke, & Paulson, 1997) | 178 randomized; 163 retained; Underpowered | ACT | Case manager | No mention | Yes | Consumer provided ACT had fewer people using hospital and ER, and longer time to events in survival analyses (Clarke), but did not differ from ACT in engagement and treatment retention (Herinckx) |
| (Craig, 2004) | 45; Underpowered | CM | Social/recreational activities | Informal | Weak | Consumer group had better engagement in services, more involvement in activities, fewer unmet needs, but did not differ in social networks or satisfaction with services |
| (Davidson, 2004) | 260 randomized (follow-up sample size unclear); Adequate power | CM | Social/recreational activities | Informal | No | No significant differences on symptoms, functioning, self-esteem, satisfaction; Consumers who regularly saw non-peer partners improved, where as consumers in the peer provider group did better when they saw the partner less often |
| (Gordon, 1979) | 80; Underpowered | Broad community/CM | Social/recreational activities; liaison | No mention | Yes | Reduced hospitalization and mental health services |
| (O’Donnell, 1999) | 119 randomized, 34% dropped out; Underpowered | CM | Advocacy/adjunct CM; not required to be primary consumer | Informal | No | No difference in groups over time in functioning, disability, quality of life, burden of care and service satisfaction |
| (Rivera, et al., 2007) | 203 randomized, varying follow-up; Adequate power | ICM | Social/recreational activities | Formal | Weak | Increased social network (attributed to increased contact with staff); no differences in QOL, satisfaction, symptoms |
| (Sells, 2006) | 137; Adequate power | ACT | Case manager | Informal | Weak | Stronger relationship quality at 6 months but not 12 months on peer teams; no differences in engagement and services |
| (Solomon & Draine, 1995) | 90; Underpowered to test for equivalence | CM | case manager | Formal | No | No differences in a variety of clinical indicators including symptoms and hospital use, QOL, and satisfaction |
| Quasi-experimental, between group studies | ||||||
| (Chinman, Rosenheck, Lam, & Davidson, 2000) | 113 with Peer case managers vs. 630 with non-peer case managers; Adequate power | ICM | Case manager | No mention | No | No group differences in psychiatric symptoms, social functioning, substance abuse, and therapeutic alliance |
| (Felton et al., 1995) | 104 completed; Underpowered (3 groups) | ICM | Liaison, peer counseling | No mention | Yes | Advantages for professional peer group on QOL, more stable contacts, and fewer life problems |
| (Klein, 1998) | 10 versus 51; Underpowered | ICM | Social/recreational activities | Formal | Yes | Peer group significantly better crisis services, hospitalization, GAF, QOL, substance abuse; but fewer leisure activities |
| (Salyers, et al., 2010) | 183 ACT-IMR vs. 141 ACT; few received active CP intervention; Underpowered | ACT | IMR | Formal | Weak | No differences in self-management, hope, satisfaction, or hospital use. Those who received IMR had less hospital use within the ACT-IMR teams |
| (Schmidt, 2008) | 142; Adequate power | CM | Case manager | No mention | No | No differences in retention, hospital and crisis services |
| Pre-Post Studies | ||||||
| (Armstrong, 1995) | 16; Underpowered | Broad community/CM | Social/recreational activities | No mention | Weak | Perceived change in QOL; qualitative themes of personal development |
| (Salyers, et al., 2009) | 14; Underpowered | ACT | IMR | No mention | Weak | Improved knowledge, trend for improved recovery scale; qualitative themes of increased activities and hope |
| (Weissman, Covell, Kushner, Irwin, & Essock, 2005) | 32 initially randomized, high attrition N/A power (no statistical test) | CM | Social/recreational activities/self-help group/linkage | Formal | No | Because of attrition could only say the peer condition had better engagement in services because they could be found for follow-up. |
ACT=Assertive Community Treatment; CM = Case Management; ICM = Intensive Case Management; IMR=Illness Management and Recovery