Iain Donnelly, Programme Lead, has recently joined Fulfilling Lives Newcastle Gateshead (FLNG). In this blog Iain reflects on their Critical Time Intervention pilot.
Between June 2018 and March 2020 we piloted a Critical Time Intervention (CTI) model as an alternative to the more traditional navigation approach that we had previously used in our work supporting people experiencing multiple disadvantage.
Developed in the US, CTI is an evidence-based practice of working with a person during a transition, such as leaving prison or moving into accommodation, for a maximum period of nine-months, focusing on person-centred goals and building support networks in preparation for the end of the time-limited period. As a model, it’s relatively new in the UK and ours was one of the first full-scale pilots to happen here, so our evaluation presents a major opportunity for us to share our learning across the sector.
Our pilot: the specifics
35 people (13 women and 22 men) began the first stage of the CTI process with us, although one fifth returned to navigation support due to safeguarding issues.
We measured outcomes using the New Directions Team Assessment (NDTA), which identified an improvement in average outcomes with scores decreasing by five points to just over 24 (out of 48). There was no improvement in average outcomes as measured by the Homelessness Outcome Star.
Our client experience
We were interested in how our clients found this new way of working and identified a spectrum of experiences, outcomes and understandings of the aims and structure of the model. In possibly the closest our programme has ever come to supporting someone to achieve a ‘fulfilled life’ one client who went on to secure employment told us:
“CTI is the foundation of my life, the base, I start to stay on my own feet, and then carry on like what I have been doing.”
However, this should be taken in the context of the wider pilot where outcomes and goals realised varied. Some people experienced outcomes such as maintaining new tenancies and addressing substance misuse, and we saw some limited success in the development of support networks, but risk and safeguarding concerns often came into play and impacted on our fidelity to the model. We share more experiences from our clients here.
Our learning and recommendations to others
Evidence from our pilot suggests that CTI is more appropriate for some groups of people than others, namely:
- CTI can work well for men who have already attained a level of stability in their lives;
- CTI is less appropriate for people experiencing crisis and people who find it difficult to build and maintain healthy relationships (which includes people with experience of complex trauma);
- CTI tends not to work well for women experiencing multiple disadvantage because of the need for longer term support tailored to women’s needs.
Based on this evidence, we are not recommending CTI as a generic approach for people experiencing multiple disadvantage. However, we think there is value in CTI being considered as a targeted model for discrete groups who meet certain criteria or as the second stage in a two-step model of support which would begin with a more traditional navigator approach.
And for us as a programme?
As well as giving us on the ground experience of a new way of working, the pilot has given us a much deeper and richer understanding of people’s experiences of transitions, which is invaluable regardless of which model of support you provide.
Our pilot highlighted the need for staff skillsets to be grounded in coaching, advocacy, relationship-building and trauma-informed approaches. Our frontline team found implementing a new model of working, whilst still delivering a navigation model challenging, and this was a different role to that which they were recruited to. We discuss these operational challenges in our interim evaluation which talks through how we implemented the model locally.
Learning, collaboration and hope are at the heart of Fulfilling Lives and for me this pilot embodies these values. We’re now in the final two years of Fulfilling Lives Newcastle Gateshead with the pilot bringing to a close our frontline work, leaving us in a strong position to consolidate the learning from across our programme and concentrate on getting it to the heart of the system to help shape how other services are delivered in the future.
Read more about partnerships’ learning from ending frontline work here.