The Tool for Measurement of ACT (TMACT) consists of a protocol intended to guide administration and scoring of the TMACT.
A TMACT review is typically conducted by two trained TMACT evaluators, who are ideally independent from the program being reviewed. After some initial information is gathered from the team prior to the onsite review, trained evaluators spend two days with the team to obtain needed data to rate the team across the 47 items. Data sources include: team member interviews, service recipient interviews, chart reviews, observation of team meetings and other practices, and review of team tools. Following a TMACT review, a final report is encouraged to document findings and recommendations as the final product. An example of such a report is included in the TMACT Appendix.
We recommend that TMACT evaluators have a strong understanding of the Assertive Community Treatment (ACT) model. Several items involve some rater judgment based on overall impressions; therefore, a valid rating will be more likely if the evaluator understands the underlying philosophy of that particular element of ACT.
Fidelity assessments should also be administered by individuals who have experience and training in interviewing and data collection procedures (including chart reviews), in addition to how to use the TMACT.
Currently there is no formal TMACT evaluator endorsement, certifying that they meet an adequate level of competency. No user is authorized to provide TMACT training while also financially benefiting from this training without a written agreement by at least two of the TMACT authors endorsing this individual as a capable TMACT Trainer.
A recommended training model includes the following:
- A didactic one-day workshop on the TMACT;
- Participatory training where the trainees assist more skilled fidelity evaluators in conducting a fidelity assessment using the TMACT (e.g., they simultaneously collect data, help review charts, rate items independently, participate in establishing consensus ratings, and review and edit written fidelity reports);
- Trainee-led evaluation of a team while being shadowed by a skilled fidelity evaluator; and
- A plan for supervising trainees’ oral and written feedback to assure reliability and validity of ratings, and the development of consultation skills for the reviewed teams.