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Promising Program Seal

Rochester Forensic Assertive Community Treatment (R-FACT)

Blueprints Program Rating: Promising

An outpatient treatment program to reduce recidivism and promote recovery among justice-involved adults with a serious mental illness.

Program Outcomes

  • Adult Crime

Program Type

  • Adult Crime Prevention

Program Setting

  • Adult Corrections
  • Mental Health/Treatment Center
  • Transitional Between Contexts

Continuum of Intervention

  • Indicated Prevention (Early Symptoms of Problem)

Age

  • Adult

Gender

  • Male and Female

Race/Ethnicity

  • All Race/Ethnicity

Endorsements

  • Blueprints: Promising

Program Information Contact

J. Steven Lamberti, M.D.
University of Rochester Medical Center, Department of Psychiatry
Strong Ties Clinic
2613 West Henrietta Road
Rochester, NY 14623
Email: steve_lamberti@urmc.rochester.edu

Training and Technical Assistance:
Community Forensic Interventions, LLC
www.Commfit.org

Program Developer/Owner

  • J. Steven Lamberti, M.D. / Robert L. Weisman, D.O.
  • University of Rochester Medical Center, Department of Psychiatry

Brief Description of the Program

The Rochester Forensic Assertive Community Treatment (R-FACT) model is an adaptation of assertive community treatment (ACT), developed to prevent psychiatric hospitalization and promote housing stability. However, ACT alone has not been shown to reduce recidivism. R-FACT adapts the ACT model by targeting criminogenic risk factors, utilizing legal authority to promote engagement, and emphasizing mental health and criminal justice collaboration to promote effective problem solving. These elements distinguish R-FACT from ACT and from other FACT-type interventions. By targeting the drivers of crime and emphasizing shared problem solving, R-FACT represents a criminologically-informed hybrid that combines practices from the fields of mental health and community corrections.

See: Full Description

Outcomes

Lamberti et al. (2017) found that compared to control, at posttest offenders in the treatment group had, on average, significantly fewer:

  • convictions
  • days spent in jail

In terms of risk & protective factors, at the posttest, treatment offenders (compared to control) had, on average, significantly:

  • more days in outpatient mental health treatment
  • fewer days in the hospital

Subgroup Details

Not conducted.

Risk and Protective Factors

Risk Factors
  • Individual: Antisocial/aggressive behavior, Substance use
  • Peer: Interaction with antisocial peers
  • Family: Family conflict/violence
Protective Factors
  • Individual: Coping Skills, Prosocial involvement
  • Peer: Interaction with prosocial peers

Training and Technical Assistance

Community Forensic Interventions, LLC (www.Commfit.org) provides training and technical assistance services that are tailored to meet community needs, whether starting a new FACT program or optimizing an existing one. For locales interested in starting a new FACT program using the Rochester model, training is provided through a combination of on-site interactive workshops and teleconference meetings. All training activities are enhanced through the use of printed and video-based materials.

Depending upon local needs, the training curriculum generally consists of three live trainings over a 12-month period. The trainings include a two-day “kick-off” training, followed by two additional day-long trainings at 6 and 12 months. In addition, regular teleconferences are held to promote skill acquisition and to address implementation barriers as they arise. Training covers key elements of program development, implementation, operation and evaluation. Training topics include:

  • How the Rochester FACT model (R-FACT) differs from ACT
  • Building community stakeholder support
  • Establishing program admission and discharge criteria
  • Integrating criminogenic risk and needs assessment into treatment planning
  • Building effective mental health - criminal justice collaborations
  • Promoting engagement of diverse consumer populations
  • Ensuring trauma-informed care delivery
  • Ensuring safe practice in high-risk community settings
  • Monitoring and ensuring fidelity of R-FACT services
  • Assessing program outcomes

Brief Evaluation Methodology

Lamberti et al. (2017) conducted a randomized control trial in which 70 offenders with a diagnosis of severe mental illness who were recruited and participated in the study between February 10, 2011, and May 14, 2014 were randomly assigned to R-FACT or enhanced treatment as usual. Data were collected at baseline and after a one-year intervention period. Outcomes included recidivism rates and use of psychiatric hospital and outpatient mental health services. All participants (treatment and control) entered the study under a conditional discharge status, whereby their pre-enrollment sentences were suspended pending successful compliance with legal stipulations that included accepting mental health treatment and avoiding further criminal activity.