Critical Time Intervention: Model Description and Implications for the Significance of Timing in Social Work Interventions

Abstract

Relatively little attention has been paid to the dimension of time in the design of social work interventions. Critical time intervention (CTI), an empirically supported psychosocial intervention intended to reduce the risk of homelessness by enhancing continuity of support for individuals with severe mental illness (SMI) during the transition from institutions to community living, is a model that was explicitly developed to address a timing-specific need. After describing the model and summarizing research that supports its effectiveness, this article considers examples of other time-sensitive interventions in social work and related fields and speculates on some potential advantages to such strategies. Further attention to various dimensions of timing in the design and evaluation of social work interventions is warranted.

Critical Time Intervention for People Leaving Shelters in the Netherlands: Assessing Fidelity and Exploring Facilitators and Barriers

“…Gradually, responsibility for the client’s care is transferred from the CTI worker to significant members from the client’s social and professional support system (Herman et al 2007). Timing is crucial: An important principle of the model is that the CTI worker and the client have started building a working relationship before the actual transition begins (Herman and Mandiberg 2010).

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“…The CTI fidelity scale has been applied in a number of settings; however, this scale has not been formally validated so far (Herman and Mandiberg 2010). For the purpose of the two RCTs, the fidelity scale was adapted in consultation with the original authors and translated into Dutch.…”

“…Secondly, we set out to compare the level of fidelity between two distinct service delivery systems—services for homeless people and services for abused women—which was possible because the two RCTs on CTI employed the same ongoing training and monitoring efforts during the same period in each service delivery system (Lako et al 2013). Earlier studies of the effectiveness of CTI have already demonstrated that the CTI model can be successfully adapted for several types of populations (Herman and Mandiberg 2010). However, the hypothesis that CTI is suitable for a range of populations would be supported further if similar levels of model fidelity could be obtained in different service delivery contexts with the same implementation approach.…”

The Role of a Critical Time Intervention on the Experience of Continuity of Care Among Persons With Severe Mental Illness After Hospital Discharge

“…The three-phase CTI intervention is described in detail in previous publications (Susser et al, 1997; Herman and Mandiberg, 2010; Herman et al, 2011). Phase 1 consisted of a CTI worker engaging and providing extensive individualized support for participants following discharge from the transitional residence, focusing on areas critical for successful community adjustment.…”

Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial

“…Critical Time Intervention (CTI) is an evidence-based practice that has been shown to effectively prepare adults with serious mental illness for critical transitions through the use of three distinct phases of practice [36]. Herman and colleagues have documented that time-limited case management focused on ‘linking’ individuals to needed services can lead to effects that are enduring for adults with mental illness through careful transition planning and the development of ongoing supports in the community [37].…”