Treatment of Youth with Bipolar Disorder and Substance Use: The Youth ACT Care Model and Self Determination Theory

Youth Assertive Community Treatment (Youth ACT) is a rising novel community based care model for youth with pervasive psychiatric illness. This type of intensive treatment follows specific principles which include an interdisciplinary team, small caseloads, 24/7 access to the team, and treatment given in the patient’s home or community. A variety of studies have reviewed outcomes and generally report that patients have statistically significant improvements in symptoms. However, much is still not well understood about how this model works, how it is applied, or about the clinical significance of the models. There have been relatively few case studies written outlining how patients respond to the Youth ACT interventions. To better understand Youth ACT, how it works, and what patients may benefit from this level of treatment, a clinical scenario is discussed. This clinical scenario involves a 15-year-old male youth with bipolar 1 disorder, psychosis and ongoing substance use. This case is indicative of the severe psychiatric symptoms that the Youth ACT teams address in the community. After case presentation, outcomes are discussed and significant clinical improvement is reflected upon.