Best Practices
What is an evidence-based practice?
An evidence-based practice (EBP) is commonly accepted as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of a client. Such practice is generally deemed evidence based only if research has proven significant positive outcomes in two or more controlled studies.
Within the field of homelessness, housing and services, the promotion and use of evidence-based practices continues to grow. While many factors play a role in the increased utilization of EBPs, there are two factors that stand out. First, EPBs have proven to be more effective in producing positive outcomes for clients served than their traditional counterparts. Since the goal of providers is to best serve their clients, EBPs have been rapidly adopted. Second, resource scarcity across the spectrum has heightened the sensitivity to outcomes in all fields of care and service. The proven cost-effectiveness of most EBPs is often a significant cause for the adoption of such practices.
Below you will find some of the major EPBs utilized in the field of homelessness, housing and services. If you are interested in connecting with a New Hampshire organization currently utilizing any of these best practices, reach out to NH Coalition to End Homelessness here: info@nhceh.org
If you are interested in researching additional best practices or evidenced-based practices, you can visit these resources:
United States Interagency Council on Homelessness
https://www.usich.gov/tools-for-action/
US SAMHSA Department’s Evidence-Based Practices Resource Center
https://www.samhsa.gov/resource-search/ebp which is an online database of various EPBs related to mental health and substance use disorders.
Assertive Community Treatment (ACT) is a team-based model designed to provide comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with serious mental illnesses. Research has shown that ACT programs can support individuals with the most severe mental illnesses by providing flexible services around the clock. ACT has been proven to reduce hospital stays and length of incarceration in the communities it has been implemented. Use the links below to learn more about ACT and to download tools and resources for implementing ACT.
ACT Resources:
Critical Time Intervention (CTI) is a homeless prevention model of time-limited case management focused on supporting people with serious mental illnesses that are being discharged from institutional facilities. Research has proven CTI programs to be cost-effective in comparison to other case management models. In addition, clients that received CTI services were much more likely to retain housing than clients that received typical post-discharge services. Use the links below to learn more about CTI and to download tools and resources for implementing CTI.
CTI Resources:
Housing First is an approach to house individuals and families who are experiencing homelessness who have serious mental illnesses and co-occurring substance use disorders. This model takes a consumer-based approach in supporting client’s needs and encouraging clients to create and implement their own goals while immediately housing clients with no preconditions (except complying with a standard lease agreement). Research has shown that Housing First programs increase housing stability for clients served, are cost effective compared to traditional services that impose abstinence perquisites to housing and increase client utilization of other supportive services. Use the links below to learn more about Housing First and to download tools and resources for implementing Housing First.
Housing First Resources:
Housing First General Info
Organizational Change for Housing First
Housing First Checklist
Motivational Interviewing (MI) is a goal-oriented style of case management and counseling that supports clients in exploring and resolving their ambivalence toward illicit and detrimental lifestyles to promote behavioral change. Motivational Enhancement Therapy (MET) is a slight alternative to MI in that MET uses an empathetic but direct approach at providing feedback to clients in a normative style to enhance and solidify the client’s commitment to change. Research has proven that programs implementing MI and MET styles have reduced a variety of problematic behaviors, including behaviors related to substance use. Use the links below to learn more about MI and MET and to download tools and resources for implementing these evidence based practices.
MET/MI Resources:
Permanent Supportive Housing (PSH) is model of providing safe, decent, and affordable housing and services to eligible clients. PSH connects clients with supportive services personnel who provide wrap-around case management services to clients serviced in collaboration with property management personnel. Research has shown clients serviced by PSH programs have increased housing stability while reducing institutional stays. Use the links below to learn more about PSH and to download tools and resources for implementing PSH.
PSH Resources:
PSH General Info
Guide for Integrating Property Management and PSH
HUD – PSH for People with SMI
Trauma Informed Care is an approach to help engage people with trauma histories in a manner that recognizes the presences of trauma symptoms and acknowledges the role trauma has played in people’s lives. Several intervention models have been developed to implement Trauma Informed Care strategies, including Addiction and Trauma Recovery Integration Model (ATRIUM), Seeking Safety, and the Sanctuary Model. Use the links below to learn more about Trauma Informed Care and to download tools and resources for implementing this model.
Trauma Informed Care Resources:
Trauma Informed Care General Info
Trauma-Informed Approach Research
A Guide for Creating Trauma Informed Approach
Harm Reduction supports policies and practices that aim to reduce the negative effect of drug and alcohol use. It is an umbrella term that describes interventions applied to programs and policies with the specific aim to minimize the health, social and economic consequences of substance use. It recognizes that while some people who use substances may not necessarily require treatment, it is helpful for them to be aware of resources that can help minimize the harm from their substance use.