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An emerging focus of Assertive Community Treatment (ACT) teams is the transition of clients to less intensive services, which creates space for individuals in need of ACT and is consistent with a recovery orientation of treatment. However, there is limited research on team transition rates, post-ACT services, and strategies to overcome transition barriers. In addition, few studies have examined differences in these factors among urban and rural ACT teams. To address these knowledge gaps, we interviewed eight ACT teams in urban and rural areas of eastern Ontario regarding their transition rates, processes of transitioning ACT clients to less intensive services, transition barriers, and solutions to overcoming these barriers. On average, teams transitioned about 6% of their clients over our 3-year study period. Urban and rural teams described both similar and distinct clinical and systemic barriers, such as client reluctance to transition and finding psychiatric follow-up outside of ACT. Implications for ACT practice and policy are discussed.

This study assessed adults’ motivations in the pursuit of well-being at different ages across the adult lifespan, examining females and males separately. We studied four major well-being motivations: eudaimonic motivation (seeking meaning, authenticity, excellence, and growth), hedonic pleasure motivation (seeking pleasure, enjoyment, and fun), hedonic comfort motivation (seeking comfort, relaxation, ease, and painlessness) and extrinsic motivation (seeking money, power, status, popularity, and image). A sample of 1324 North American adults, aged 18–87, was stratified to ensure sufficient sample sizes at different age ranges and to ensure sufficient numbers of males and females within each age range. Participants completed the Hedonic, Eudaimonic, and Extrinsic Motives for Activities (HEEMA) scale, an updated version of the HEMA scale originally developed by Huta and Ryan (J Happiness Studi 11:735–762, 2010). For females, eudaimonic motivation increased until the 30s and did not change significantly thereafter; for males, eudaimonic motivation decreased from the 30s to the 40s, but then increased from the 40s to the 60s. For both genders, hedonic pleasure motivation decreased from the 30s onwards, though males scored significantly higher than females in the 20s. There was not much change in hedonic comfort motivation, except that it decreased from the 30s to the 50s in males. For both genders, extrinsic motivation decreased to the 60s, though males scored higher than females in the 20s and 30s. The results are interpreted in terms of gender roles, developmental theories, and biological changes.

Epidemiological reviews report a significant percentage (between 5%- 28%) of people in the general population experience what is clinically known as auditory verbal hallucinations (AVH) or \"voices\". Psychotropic medications are often used to treat auditory verbal hallucinations. However, group therapy has been found to be an effective therapeutic intervention for this population, but there is limited research on which factors lead to positive outcomes for clients who attend these groups. Furthermore, current research appears to focus on clients' viewpoints regarding what constitutes a \"good outcome,” and there has been very little research focusing on the perspectives of auditory verbal hallucinations (AVH) group facilitators. The purpose of this study was to discover what facilitators of AVH groups viewed as positive group outcomes, and to explore the most important factors, per group facilitators, in generating positive outcomes within a group modality for this client population. This study was a qualitative analysis, specifically employing a cross case analysis approach. Ten group facilitators from around the world who have experience running groups for clients with auditory verbal hallucinations were interviewed. Six themes emerged: Flexibility, Group Process, Empowerment, Self Awareness, Safety, and Lived Experience.

Alison, 6, and Rebecca Zangrilli, 4, climb aboard the big yellow school bus at Christ the King...

\"People think 'oh, maybe I'm imagining (threatening behaviour),'\" [Maureen Andrew] says. \"If you're asking yourself that question, you probably aren't imagining it.\" \"Realtors go to these locations and it's just them and whoever they're meeting,\" Andrew said. \"The two of them are alone together behind a locked door.\" \"Real estate people become victims because they want the sale,\" Andrew said. \"It's hard to walk away from all that money because they feel unsafe.\"

\"People think 'oh, maybe I'm imagining (threatening behaviour),'\" [Maureen Andrew] says. \"If you're asking yourself that question, you probably aren't imagining it.\" \"Realtors go to these locations and it's just them and whoever they're meeting,\" Andrew said. \"The two of them are alone together behind a locked door.\" \"Real estate people become victims because they want the sale,\" Andrew said. \"It's hard to walk away from all that money because they feel unsafe.\"

\"On Friday we had some rain-- what farmers call a 'shirt-wetter,'\" said Nurse, the president of the agricultural society. \"The wind was enough to scare you. We thought the tents were going to blow away!\" \"We took a big chance hiring the lumberjack competition,\" said Nurse. \"It was the most expensive act for us. We didn't know if it would bring enough people to the fair to pay for it.\" \"We mingle the stuff we want them to see with fun stuff, like the demo derby,\" he said with a laugh. \"It's like Mary Poppins: a spoonful of sugar helps the medicine go down.\"

\"It's really joyful to see that,\" she says. \"There's nothing more rewarding than having a child you taught come home from university and give you a big hug.\" \"It's never too late to start!\" [Joanne Brown] says, adding that playing music can help adults fight neurological diseases like Alzheimer's by developing neuro endings.

\"Acupuncture is like going to the gym for the nervous system,\" [Brendan Cleary] says. \"It stimulates your body to help itself. Like working out, it takes time for your body to learn.\" \"The thing about migraines is that people are desperate to find an answer. They are totally incapacitated and it totally arrests their life,\" Cleary says. \"They have tried everything available and are at the end of their rope when the come to see me.\"

\"Don't pop a pill because you think you should,\" says Carol Harper, the TOPS co-ordinator for the London-Niagara region, which includes Halton Hills. The Acton chapter of TOPS meets Mondays at St. Joseph Catholic Church. The Georgetown chapter meets Tuesdays at St. Andrew's United Church. For more information, visit www.tops.org or contact Carol Harper by phone at 905-877-7056 or by e-mail at charper3@cogeco.ca.