Could Critical Time Intervention work in England?

Friday, 7 July 2017 - 4:00pm

Having travelled to America to experience different approaches to working with people who are homeless, I shared some of my learning at Homeless Link’s annual conference.

Homeless Link’s Transatlantic Practice Exchange, funded by the Oak Foundation, is an opportunity to share innovative ways of working between the US and the UK. In May I was able to visit Los Angeles (LA), California to work with Brilliant Corners.

Brilliant Corners is a supportive housing agency offering support to vulnerable people transitioning out of homelessness or institutional settings. One specific programme, Breaking Barriers, works with homeless individuals on probation and offers case management support through the model of Critical Time Intervention (CTI).

CTI is designed as a simple intervention to be used during a transition period, but which builds the foundations for lasting long-term support within the community.

The CTI model is based on moving through clear, time-limited phases that are agreed and appropriate for the model or programme of support. Ideally, a case manager (support worker) will start to build a relationship whilst the individual is still in the institution, for example prison, hospital or emergency housing, and at the point of transition into the community there are three distinct phases which are followed: 

Transition

This is the most intensive support phase, with the case manager implementing the transition plan and providing emotional support. The worker will often act as a negotiator and smooth potential conflicts during transition.

Try-out

At this stage, the worker takes a step back to observe how the person is settling into their community of support. The worker is available to step back in where there is a crisis point. 

Transfer

The final stage is the transfer of care into the support systems that have been created. During this phase, there will be an explicit set of activities which solidify the support system that is in place. Ideally there will be a final meeting with all parties to allow reflection and ensure there is a planned ending to the client-worker relationship. 

CTI was first introduced in 1990s in New York, and is now an empirically proven model, with a number of studies across the US showing that tenancy sustainment is significantly increased for people being supported through the CTI model. In LA, the tenancy sustainment rate is currently at 83%, and in studies using a control group, there was a 66% increased sustainment rate. Work has largely focused on the US and also in some parts of Europe, but there have been limited trials in the UK to date.

At Homeless Link's Under One Roof conference in July, we held a workshop to introduce CTI to colleagues in the UK.

We delivered the session to around 40 colleagues and we are excited to hear that some areas in the UK, such as Manchester and London, are looking to secure funding to pilot a CTI model over the coming months – we might even create a UK CTI network! In the meantime, if you are interested to learn more about CTI, please sign up to criticaltime.org and use the excellent resources that are available.   

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Alex Smith

System Broker - Fulfilling Lives

Alex is a System Broker with Fulfilling Lives, which seeks to help people with complex needs better manage their lives, by ensuring that services are more tailored and better connected to each other.

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