Critical Time Intervention » research

CTI judged among “top-tier” social programs

Dan Herman — Tue, 15 Nov 2011 22:07:34 +0000

The highly regarded Coalition for Evidence-Based Policy has announced that CTI meets the Congressional Top Tier evidence standard as an effective social program. This standard, identified in recent legislative language, is “well-designed randomized controlled trials [showing] sizeable, sustained effects on important…outcomes.” The Coalition is a nonprofit, nonpartisan organization that works closely with key Executive Branch and Congressional officials to help promote dissemination of the most promising social interventions.

CTI researchers convene in Buenos Aries

Dan Herman — Fri, 23 Sep 2011 22:33:29 +0000

Investigators from four countries gathered on September 22 to describe their current research at a symposium held at the World Congress of Psychiatry in Buenos Aries, Argentina, sponsored by the World Psychiatric Association. Participants included Dan Herman (US), Ezra Susser (US), Graham Thornicroft (UK), Elie Valencia (Brazil), Judith Wolff (Netherlands). Thornicroft and colleagues are conducting a randomized trial of CTI with persons with mental illness being released from correctional facilities in London and Manchester, while Valencia reported on work his group is carrying out using CTI in the favelas of Rio De Janeiro. Wolff leads a large multi-site randomized trial testing an adapted version of the model with homeless persons and women who have experienced interpersonal violence.

Latest trial yields positive results

Dan Herman — Wed, 06 Jul 2011 15:52:43 +0000

Psychiatric Services has published the findings of the most recent randomized trial of CTI with people with severe mental illness following discharge from psychiatric hospitals. 150 previously homeless men and women with severe mental illness and who were discharged from inpatient psychiatric hospitalization to transitional residences on the hospital grounds were randomly assigned to receive usual care or usual care plus CTI at the point of discharge to the community. Following discharge, participants’ housing status was assessed every six weeks for 18 months. An intent-to-treat analysis demonstrated that participants assigned to the CTI group had significantly less homelessness at the end of the follow-up period, supporting the idea that a targeted, relatively short intervention applied at a critical transition point can enhance the efficacy of long-term supports for persons with severe mental illness who are living in the community. A free full-text version of the article is available here.

Multi-site CTI trials launch in Netherlands

Dan Herman — Fri, 03 Dec 2010 17:15:32 +0000

The Netherlands Center for Social Care Research at Radboud University Nijmegen Medical Centre, with funding from the national government, has launched two randomized controlled trials to assess the effectiveness of CTI in Dutch services for homeless people and victims of domestic violence. The studies investigate whether combining Critical Time Intervention (CTI) with the typical strengths-based social work approach is more effective than the strengths-based methodology alone in improving housing and other outcomes. The homeless sector trial will include adult clients of 9 shelters, examining whether CTI leads to fewer days of homelessness (primary outcome measure). The trial in the women’s shelter sector targets adult female clients of 8 facilities who have experienced violent abuse and examines how CTI affects their quality of life (primary outcome measure). Teams have been trained in the interventions and data collection is set to begin shortly. The study is led by Dr. Judith Wolf with collaborators Renee de Vet, Danielle Lako, and Marielle Beijersbergen. A kickoff meeting (see photo), held on November 18 in Utrecht, was attended by service providers, researchers and CTI experts from the Netherlands and the US including Dan Herman of Columbia University.

New paper explores broader implications of CTI for timing of social service interventions

Dan Herman — Thu, 26 Aug 2010 20:57:46 +0000

Relatively little attention has been paid to the dimension of time in the design of social work interventions. CTI is an example of an intervention that was explicitly developed to address a timing-specific need (enhancing continuity of care during transitions between institutional and community living). After describing the model and summarizing research that supports its effectiveness, this new article by Dan Herman and Jim Mandiberg of Columbia University considers examples of other time-sensitive interventions in social work and related fields and speculates on some potential advantages to such strategies. The authors conclude that further attention to various dimensions of timing in the design and evaluation of human service interventions is warranted

NIH conference features web-based training pilot

Dan Herman — Wed, 17 Mar 2010 16:27:27 +0000

Jeffrey Olivet and Sam Johnston (both from the Center for Social Innovation) and Dan Herman (Columbia University & New York State Psychiatric Institute) led a panel presentation at the 3rd Annual NIH Conference on the Science of Dissemination and Implementation held in Bethesda on March 15 and 16, 2010. The team described findings from their recently completed pilot study of web-based CTI training for social workers and other staff working in homelessness service settings. This study, a collaborative project carried out with support from NIMH, tested a virtual community of practice approach to supporting providers as they developed needed skills and specific plans to implement CTI in their organizations.

Project ASPIRE presented at ABCT conference

Dan Herman — Thu, 03 Dec 2009 21:58:04 +0000

Clinicians and researchers from the Institute for Community Living, Inc., presented a poster evaluating the effectiveness of Project ASPIRE at the annual meeting of the Association for Behavioral and Cognitive Therapies held last month in New York City. Project ASPIRE is an award-winning SAMHSA-funded demonstration program that applies CTI and other evidence based approaches to help women with mental health and substance use problems successfully transition from a homeless shelter to stable life in the community. For more information on the program or the evaluation, contact Dr. Elizabeth Cleek at elizabeth.cleek@iclinc.net

CTI symposium features international collaboration

Dan Herman — Wed, 14 Oct 2009 22:50:39 +0000

The Institute on Psychiatric Services, an annual meeting of community-based psychiatrists organized by the American Psychiatric Association, was the site of a well-attended symposium on CTI held on October 11, 2009. The symposium, organized by Bert van Hemert of the ParnassiaBavo Group and Leiden University in the Netherlands and Dan Herman of New York State Psychiatric Institute & Columbia University, featured presentations by researchers studying adaptations of CTI in diverse settings including US prisons (Jeffrey Draine) and community-based mental health clinics in Rio De Janeiro (Elie Valencia). Other speakers included Lewis Opler, who reported on the impact of CTI on psychiatric symptoms in two US trials. Sarah Conover of New York State Psychiatric Institute & Columbia University served as discussant.

CTI informs pilot ACT transition model in New York State

Dan Herman — Fri, 03 Apr 2009 18:47:10 +0000

For persons with severe mental illness, the transition from assertive community treatment (ACT) to less intensive services is a vulnerable period during which enhanced support is especially vital. The ACT Transitions Model, adapted in part from CTI, is a framework designed to enhance the coordination and continuity of care of service recipients who are moving from ACT to less intensive services. A workgroup of stakeholders developed the model to be delivered in the following three phases over a nine-month period: (1) Transition Planning, (2) Try-Out, and (3) Fine Tuning, Transfer of Care and Follow-up. The stakeholder workgroup included ACT staff and consumers as well as representatives of the New York State Office of Mental Health and the New York City Department of Health and Mental Hygiene. The model will be piloted and evaluated over the next two years. The project is a New York State Office of Mental Health initiative funded by the Bristol-Myers Squibb Foundation (PI, Molly Finnerty, M.D.) For further information, contact Jennifer Manuel at coevjim@omh.state.ny.us or 212.543.5164.

Using a brief CTI to promote continuity of care after inpatient hospitalization

Dan Herman — Thu, 02 Apr 2009 19:57:08 +0000

Lisa Dixon of the University of Maryland and colleagues have published a new experimental study assessing the effectiveness of a brief three-month adaptation of CTI in enhancing continuity of outpatient psychiatric treatment for persons with serious mental illness following discharge from inpatient care. Among the findings were that, compared with the control group, persons assigned to receive the intervention had significantly fewer days between their hospital discharge and their first outpatient service. The authors conclude that the intervention successfully promoted post-discharge continuity of care, but caution that the limited association between improved continuity and improved patient outcomes requires further study.