Role of context, resources, and target population in the fidelity of critical time intervention

Abstract

Objective: The goal of this study was to understand departures from a model program, critical time intervention (CTI), when used with a population of men with mental illness who were leaving prison, a new population for the intervention. Methods: A fidelity study was conducted with the CTI Fidelity Scale Manual, and six program staff participated in semistructured interviews. Thematic analysis of interviews supplemented information on departures from the model. Results: The overall fidelity score indicated awell-implemented program, but low scores on early engagement, early linkingwith community resources, monitoring the transfer of services from CTI to community services, and nine-month followup were related to the context of the prison setting, the population of men leaving prison, and environmental resources. Conclusions: The setting in which evidence-based practices are applied, the environmental resources available, and the target population may affect program fidelity.