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Community & Behavioral Health | Recovery | Social Change


Changing the Conversation

Six Reasons to Implement Critical Time Intervention

02/25/16 02:09 PM | Tom Bardwell & Collin Whelley | Homelessness, Case Management, Critical Time Intervention

Critical Time Intervention

Critical Time Intervention (CTI) is a case management model originally designed to prevent recurrent homelessness by connecting individuals with supports in their community. It provides flexible, individualized, and focused support after a person transitions from shelter to housing. Here are six reasons CTI might be just what your community needs:

  1. CTI can reach more people than other models.

CTI is a 9-month, time-limited model. When implemented with fidelity, your CTI program will create room for more people by systematically decreasing the intensity of care as people phase-out of the intervention. Some individuals requiring intensive services may not be the best fit for CTI. However, many people are just the right fit. Moreover, the CTI model can be applied in many transitional situations such as homelessness to housing, jail to community, and institution to housing. In this way, your CTI program can be molded to support individuals with a diversity of needs.

  1. CTI can help your clients sustain housing.

CTI helps individuals maintain housing when team members are familiar with substance use, motivational interviewing, and assessing system resources, including staff dedicated to managing client housing applications. This evidence-based model can help your agency if it can provide the following structure:

  • Opportunities to build the relationship with clients before starting a CTI program;
  • Staff to manage housing applications; and
  • Harm Reduction approach to substance use.

This structure will help agencies understand the reality of their clients’ lives, including how they grapple with the obstacles and challenges, make decisions, and take advantage of available community resources. Each member of your CTI program has a role in strengthening connections and establishing new linkages to improve client integration in their communities over the long-term. The most important outcome of this approach is to strengthen an individual’s community supports to lessen his/her need for services.

  1. CTI can help bring community supports together.

The CTI team operates in the community and spends less time in the office recording information about client needs. They accompany their clients to meetings, explore their neighborhood with them, and talk to family members and other supportive people they know in the community.

The CTI design requires team members to work extensively in the communities where their clients live and access services. When communities work together to solve complex public health issues, like homelessness, the individuals utilizing services have a better chance of integrating into the community and excelling.

  1. CTI helps when resources are limited.

The CTI model has the potential to help communities address complex and costly issues by utilizing formal (e.g., pharmacists, mental health counselors) and informal (e.g., peer support groups, faith-based organizations) supports and by building upon these networks. Again, the CTI model reaches many more potential supports because of its adaptability across different critical transitions and its time limits.

  1. CTI is focused and client directed.

CTI models are designed to focus on a finite number of critical issues in a person’s life rather than trying to address every issue. CTI workers explore a person’s wishes and desires with the purpose of identifying areas of focus. In this way, CTI is individualized. Keep in mind that no two people are alike, and thus, CTI will look different for every team and every person who goes through the intervention.

  1. CTI works.

Research shows that the CTI model works when implemented with fidelity. In addition to CTI’s success, the model employs many of the same key components used in other evidence based practices—such as Housing First, assertive community treatment, motivational interviewing, and Harm Reduction. Taken together, this model is very effective in helping people stabilize in the community over the long-term.

Join Tom and Collin for t3's course on CTI starting March 3:

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About the Authors:

Tom Bardwell is a Senior Analyst at the Center for Social Innovation and a t3 faculty member. He is a public health professional specializing in training and technical assistance on Harm Reduction. He is also one of the founding artists of Boston LGBTQIA Artist Alliance, a nonprofit that builds community through exhibition opportunities. Tom received his B.A. from Hiram College and his Masters in Theatre Education from Emerson College. 

Collin Whelley is a Senior Analyst at the Center for Social Innovation and a t3 faculty member. He has been working in the field of homelessness and poverty for more than 9 years. From a street outreach worker to an academic researcher, Collin has been searching for new ways to address issues related to homelessness and poverty. His current interests include program and best practice implementation and evaluation as well as the politics of social justice.

Image by Lainey Powell (CC by 2.0).