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CTI: impacts on the people we support

Alex Smith is FLNG’s former Operational Lead who played a major role in setting up our Critical Time Intervention pilot. Before she moved onto pastures new with Homeless Link in August 2019 we asked her to share her experiences of how our CTI journey began and its impact on the people we support which she has done in this series of blogs – thank you Alex! We’ll follow up these blogs with a piece from our Programme Manager Lindsay Henderson reflecting on our learning so far and sharing our current position and next steps.

Critical Time Intervention: the impact on the people we support
Alex Smith

In my last blog (available here) I described the beginnings of our Critical Time Intervention (CTI) journey and how we implemented the pilot at Fulfilling Lives Newcastle Gateshead.  In this blog, I’d like to share some examples of the impact this new way of working has had on the people we support.

Firstly, would people accept a new way of working?  Our team were fairly resistant to change and we expected a similar kind of resistance from the people we support but this was not always the case.  Most people thought CTI sounded like a good idea – something structured, some positive goals to focus on, a planned ending.  The ending.  There was the issue.  However positive CTI sounded, it all ended with an ending.  Anything but the end.  And it is true to say people were scared about it.  What will I do without you?  You’re the only one I trust!  How will I cope?  But can I still call you?  Things will fall apart without you!

I guess the question is; so far, have the endings been as bad as everybody thought they would be?  Honestly, I think the answer is no.  There have certainly been a few people where the ending has been hard, and for two people not even possible (I’ll talk about that again later on), but most people have felt well prepared for the ending and that there was a good support network in place.

One of the most positive aspects of CTI for the people we support is the focus on goals and we have had some brilliant examples of person-centred goal setting. For one person their transition was gaining leave to remain in the UK and one of their most important goals was to obtain a driving license; a sign of their status and the ability to gain employment and independence.  I met this person for a chat about their experience of CTI and they proudly displayed the driving license stating

 ‘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.’

NUFCFor another person, football is everything but after decades of living on the street it felt pretty low on the survival list of priorities.  After their transition to an independent flat life started to settle down, a move away from street life and street drinking, a renewed focus on what’s good in life and their goal: a season ticket for Newcastle United.  Often, it isn’t about the achievement of a goal but the process of collaboratively setting the goal and sharing those hopes and dreams with the wider support network so they carry this on after our work and the CTI model ends. In this instance however, we were still around to see their goal being well and truly scored – “howay the lads!”

Focussing on a maximum of three goals isn’t always easy, especially for those people experiencing ongoing crisis as resource and energy is easily taken from the goal and focussed on meeting immediate need.

Of the ten CTI closures we have had to date, nine have been positive where the person has moved into other support services or does not require ongoing support; however, one person has not benefitted from CTI with a very limited support network, no stable housing and ongoing recalls back to custody.  For two women we have supported, CTI has not been successful and due to the level of risk we have been unable to close their cases and have reverted back to a navigation model of support.  There are some key factors in relation to the success of CTI in strengthening a network of support in the community, which include:

  • Connections and family support
  • Unhealthy/ abusive relationships (trauma-bond)
  • Criminal activity and repeated recalls to custody
  • The stability of housing.

In my experience, the above issues typically affect women more greatly than men and we are seeing a trend that CTI is more effective for men, with risk/safeguarding concerns making CTI difficult to successfully implement for women.

We have recently published an interim evaluation which shares more learning from our CTI pilot – you can read this at Recent reports.  FLNG will also be publishing a blog from Programme Manager Lindsay Henderson reflecting on learning so far and sharing current position and next steps so please look out for that.  In the meantime, if you have any questions or comments please email ang.broadbridge@fulfillinglives-ng.org.uk.