Critical Time Intervention

Similar to Intensive Case Management, Critical Time Intervention (CTI) is a time-limited, intensive case management model that focuses on the goals of a client. CTI is more specifically used to help a client transition from residential to community care. In a residential setting, such as a hospital, correctional facility, foster home, shelter, rehabilitation center, or even military service, their recovery journey is completely governed by a team of professionals. It can be jarring for an individual who has spent significant time in programs like these to enter the community and return to or begin independent living. That’s why CTI exists. Case managers who use CTI see this time of transition in the client’s life as a potentially major pivot point. Using this model, the case manager and other professionals collaborate to help prepare clients for their next stages of life. Such clients need to develop a community support network in order to ensure their future success, and CTI helps build that as well as guide their transition.

Multiple Use Cases

CTI has been used in many scenarios, and is by nature meant to help prevent clients in need from falling back into patterns of isolation, neglect, or ongoing residential care. Prior to these programs, many clients come out of situations like homelessness, unemployment, disaster relief, domestic violence or instability, incarceration, hospitalization, and other areas of need. 

Similar to Intensive Case Management, however, this model will not be right for every client, because an intensive, time-limited program doesn’t work for everyone. It’s up to the case manager to work with the client, determine their level of need, and construct a program based on the client’s need and goals.

Phase 1

This model begins with the case manager cultivating a relationship with the client in order to earn their trust while the client is in a residential setting. From there, the client leaves the residential setting and begins the process of entering a community setting and progressively working toward independence. While the client is in this in-between place, the case manager and the team assigned to the client begin doing home visits to help the client develop necessary skills as they adjust to a new way of life. These home visits may include collaborative assessments that help build the case manager-client relationship, mental health counseling, job and life skills training, physical therapy, and positive habit formation. It will also involve the development of a community support team and plan that the client can understand and benefit from.

Phase 2

The middle portion of a CTI program involves case managers monitoring and strengthening the client’s skills with this network of professionals. Sometimes, the team may need to modify the plan to ensure that it works. This is also the point at which the case management team begins to encourage the client to become more independent and take on more responsibility in their ongoing plan to reach their goals. The case manager will also continue helping them develop a working system of relationships and community programs that will help them stay on track with pursuing their goals once the CTI program is over. This can include helping the client reconnect with family members or friends, find reliable volunteer work or employment, and helping the client find group or psychotherapy services. The end goal is to help the client begin to rely on this community-based structure while in a “halfway house” format.

Phase 3

The CTI phased approach ends with a transfer of care to outpatient professionals and personal support systems. At this point, the client should be prepared to resume or start a new life outside of treatment with a sense of confidence, purpose, and ownership. While the case manager will likely still be in contact with the client in order to show support, they will usually step back to allow the process to work.