ABSTRACT
For many clients intensive specialist services such as assertive outreach lie at the end of a long care pathway that has often failed to meet their complex range of changing needs or to engage them in arriving at a collaborative understanding of these needs. Commonly a referral occurs during a lengthy stay on an acute psychiatric ward where people have received a limited range of treatments. They are likely to have experienced an impoverished social environment that has low expectations of them and led to poor social functioning, or alienated them and led to further disengagement from services and clinicians. On the other hand, some people may have received a comprehensive range of therapeutic interventions but without making progress on their recovery journey.
