Suchergebnisse

Professional social workers and other mental health providers have for many years been involved in delivering treatment and support services focused on the needs of adults with severe mental illnesses living in the community. While some models have evolved largely through practice experience, others have developed through research paradigms in which program developers have attempted to systematically test their models by employing randomized trials and other rigorous approaches to assess impacts. Critical time intervention (CTI) is a time-limited care coordination model intended to prevent homelessness and other adverse outcomes among adults with severe mental illness during periods of transition. After briefly tracing its roots in assertive community treatment—a pioneering earlier model of community care—this article describes CTI, the evidence for its effectiveness, preliminary efforts toward its broad dissemination, and offers thoughts about its further development and potential for adaptation.

This study explored factors promoting and impeding formerly homeless permanent supportive housing tenants from moving into more independent community housing. Interviews were conducted with 10 current and 11 former residents. Facilitators included support received during supportive housing tenure, a focus on set goals, supportive housing as a stepping-stone, and a willingness to fight for what they hope to accomplish. Barriers included lack of affordability and rental assistance, fear of becoming homeless again, unacceptability of available housing, and limited help facilitating the transition. Permanent supportive housing residents may benefit from expanded use of support received during tenure. Affordability will likely remain a barrier. Given federal disinvestment in rental subsidies, growth in locally funded programs and other strategies will likely be required.

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.

Purpose: To support future development and refinement of social work–led intervention programs among patients with firearm injuries and to demonstrate how a fidelity assessment can be used to adjust and refine intervention delivery in an ongoing trial. Method: We conducted a fidelity assessment of a randomized controlled trial of a social work–led intervention among patients with a firearm injury. Results: We found that our study intervention was well implemented, meeting 70% of the fidelity assessment score items, however, noted lower fidelity with client-based items. Discussion: As a result of fidelity assessment findings, we refined intervention delivery to improve implementation fidelity including beginning to review cases of all patients each month rather than focusing on patients in crisis. Our fidelity assessment process and findings offer insight into the challenges of implementing an intervention among patients with firearm injuries and highlight the value of monitoring intervention fidelity during an ongoing trial.