Flexible ACT workbook

Flexible ACT workbook

Researchers at CCAF have developed a new fidelity scale to evaluate flexible assertive community treatment (FACT) - an intensive community-based treatment for people with severe mental illnesses.

It is designed as a workbook to measure FACT model fidelity, and also helps service providers start working with and evaluate the model. The workbook can help teams all over the world implement FACT by starting their own quality improvement cycle. 

FACT-teams deliver efficient and effective community care for people with severe mental illnesses, which can help countries de-institutionalize by offering a community alternative for clinical care. FACT delivers different kinds of services in a flexible manner and can intensify care during a crisis within the same team. Treatment, crisis interventions, and recovery-oriented care are given by the same multidisciplinary FACT-team. FACT prevents usage of clinical beds and promotes recovery in the community, and has been found helpful in rural and hard to reach areas thanks to its stand-alone and self-organized way of working.    

FACT is being implemented in Denmark, Sweden, Norway, Germany, Moldova, Belgium, England, Canada, Bonaire, and Aruba. It is hoped that sharing this workbook will help improve quality of care for people with severe mental illnesses and make it available in a larger network.


CCAF is a Dutch non-profit foundation run by mental health professionals, peers, and researchers in order to improve quality of care for people with severe mental illnesses. 


Treatment, care and rehabilitation
Psychosis/bipolar disorder
Central America and the Caribbean
North America