Evidence-Based 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 homeless 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 homeless housing and services.  If you are interested in a specific EPB, you can visit the National Registry of Evidence-based Programs and Practices, which is an online database of various EPBs.

Assertive Community TreatmentClick to Expand
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 jail days 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:

NAMI – ACT General Info
NAMI – ACT Outcomes Fact Sheet
Assertive Community Treatment Association
Homeless Resource Center – ACT

Critical Time Intervention (CTI)Click to Expand
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:

CTI Informational Sheet
Homeless Resource Center – CTI
NREPP – CTI Summary

Housing FirstClick to Expand
Housing Firstis an approach to house homeless individuals 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 sobriety 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:

Homeless Resource Center – Housing First
NREPP – Housing First Summary
NAEH – Organizational Change for Housing First
HUD – Housing First for Persons with SMI

Illness, Management and Recovery (IMR)Click to Expand
Illness, Management and Recovery (IMR)is an illness management model designed to help people with serious mental illnesses set meaningful goals for themselves, collaborate with professionals, reducing their susceptibility to their illness, and improving their ability to manage their symptoms.  Research has shown that by implementing this model, clients will know more about their mental illnesses, will reduce relapses and hospitalizations, will reduce distress from symptoms, and will use medications more consistently.Use the links below to learn more about IMR and to download tools and resources for implementing IMR.

IMR Resources:

Homeless Resource Center – IMR
Minnesota Department of Human Services – IMR

Integrated Dual Disorders Treatment (IDDT)Click to Expand
Integrated Dual Disorders Treatment (IDDT)is a treatment model that combines both substance use and mental health services into one program for persons with substance use disorders and serious mental illnesses.  Research has proven the IDDT models reduce hospitalizations, arrests and relapses will increasing housing stability and consumer quality-of-life outcomes for the clients served.  IDDT has also been shown to be a cost-effective method of service delivery compared to traditional-like models.Use the links below to learn more about IDDT and to download tools and resources for implementing IDDT.

IDDT Resources:

Center for Evidence Based Practices – IDDT Overview
Foothills Behavioral Health Partners – IDDT Guidelines
Homeless Resource Center – IDDT

Motivational Interviewing and Motivational Enhancement TherapyClick to Expand
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:

GoodTherapy.org – Overview of MET
Homeless Resource Center – MI and MET
NREPP – MET
NREPP – MI

Permanent Supportive Housing (PSH)Click to Expand
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:

Homeless Resource Center – PSH
Guide for Integrating Property Management and PSH
HUD – PSH for People with SMI
NAEH – Cost Savings with PSH

Wellness Recovery Action Plan (WRAP)Click to Expand
Wellness Recovery Action Plan (WRAP)is a group intervention designed to help adults with mental illness understand their personal wellness resources, or “wellness tools,” and develop an action plan to utilize those tools on a daily basis.  Research has shown clients served by WRAP reduce their mental health symptoms and improve their overall physical and mental health.Use the links below to learn more about WRAP and to download tools and resources for implementing WRAP.

WRAP Resources:

NREPP – WRAP
Personal Workbook for Participants
Mental Health Recovery

Supported EmploymentClick to Expand
Supported Employmentis a service model designed to help persons with mental illnesses participate in the competitive labor market with the goal of obtaining a job of preference.  While several variations of supported employment models exist, the individual placement and support model is accepted as the standard model of supported employment, as it promotes the six key principles of supported employment: services focused on competitive employment, eligibility based on consumer choice, rapid job search, integration of rehabilitation and mental health, attention to consumer preferences, and time-unlimited and individualized support.Use the links below to learn more about supported employment and to download tools an resources for implementing this model.

Supported Employment Resources:

Homeless Resource Center – Supported Employment
Central City Concern – Supported Employment Outcomes
Supported Employment Handbook
NAMI – Supported Employment

Trauma Informed CareClick to Expand
Trauma Informed Careis 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 an resources for implementing this model.

Trauma Informed Care Resources:

Homeless Resource Center – Supported Employment
A Guide for Creating Trauma-Informed Services
National Center on Family Homelessness – Trauma-Informed Organizational Handbook
National Center for Trauma Informed Care