We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.
ObjectivesTo examine the effectiveness of critical time intervention (CTI)—an evidence-based intervention—for abused women transitioning from women’s shelters to community living.MethodsA randomized controlled trial was conducted in nine women’s shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models.ResultsWomen in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference − 7.27, 95% CI − 14.31 to − 0.22) and a significant fourfold reduction in unmet care needs (intermediate outcome) (95% CI 0.06–0.94) compared to women in the care-as-usual group. No differences were found for quality of life (primary outcome), re-abuse, symptoms of depression, psychological distress, self-esteem (secondary outcomes), family support, and social support (intermediate outcomes).ConclusionsThis study shows that CTI is effective in a population of abused women in terms of a reduction of post-traumatic stress symptoms and unmet care needs. Because follow-up ended after the prescribed intervention period, further research is needed to determine the full long-term effects of CTI in this population.Electronic supplementary materialThe online version of this article (10.1007/s00038-017-1067-1) contains supplementary material, which is available to authorized users.
Highlights
This study contributes to a European evidence base for effective interventions for homeless people.It is the first RCT conducted in Dutch shelter services; this is uncommon outside the United States.In this sample, recurrent homelessness was rare 9 months after moving from a shelter to housing.Beneficial effects of CTI on mental health seem to be independent of health care system or context.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.