Empowering destitute people towards transforming communities

3.4CTI as a social services strategy to be used as part of “outside-in” missions

While social services such as reconnecting to housing, clinical services, health care and employment all constitute part of missions with the destitute, we must also remember that these missions are not “once-off” engagements between helpers and destitute people; rather, over a period of time, effort is invested along a “continuum of care”. Somewhere along this “continuum” destitute people may want to reintegrate themselves into society – and we must help them in their own efforts to do so. Our efforts at social services would be incomplete without this attempt. It will obviously reconnect them to a community or communities.
Susser et al. (1997:256-262) developed an approach called CTI (Critical Time Intervention) to assist previously destitute people with their successful reintegration into society. The “Critical Time” would then be the time at which a previously destitute person leaves services to re-integrate into society.
The preferred scenario, in terms of missions with the destitute, is that people should be slowly reintegrated from the first day, as they are drawn into church communities or other valued communities through outreach and engagement. In this way reintegration can happen gradually and almost spontaneously. However, this is not always possible, because destitute people are often taken up into services and programmes from which they must then reintegrate into society. This is where CTI finds its application.
Originally CTI was developed as a (long term) cost-effective programme to assist destitute people with severe mental illness in their transition from shelters to community living. However, CTI is a sound approach to use with all destitute people as they make the transition back into society (from shelters and programmes). The variable factor will be the length of time that a person receives CTI intervention. In the most severe cases, a period of 9 – 24 months is recommended, decreasing with “less severe” cases of destitute people.
Basically, CTI calls for continued and specific support as/ while people are returning into society. This support includes connection to relevant services “on the outside” (of shelters etc.), intervention in order to strengthen family and other relationships, and to continually improve life skills (when the need for such skills is tested by the demands of society).

As part of the continuum of care delivery, helpers could implement the successful strategies described in Critical Time Intervention (CTI) to prevent recurrent destituteness and promote successful transitions to housing, and reintegration into society. One component of CTI is to strengthen the relationship between the individual and family, friends, and services, and secondly to provide emotional and practical support during the critical time after discharge from a shelter or programme. Outcomes of CTI included a significant reduction in destituteness and a preliminary indication that CTI is cost-effective (Jones et al., 2003, Susser, et al., 1997). Interventions are short in duration, simple, can be implemented by nonprofessional staff, and can be implemented in marginal settings (Susser et al., 1997: 256-259).

The principal components of CTI encompass rapid placement in transitional housing, continued treatment by means of services, networking with different services and brokering and monitoring the appropriate support arrangements to ensure continuity of care.

Requirements for CTI will include case workers, constant follow-up (weekly if possible) and brokering agreements with agencies and institutions to help the previous destitute person for the necessary time frame, which may vary from person to person (Susser et al., 1997:259 - 260).

CTI as an approach is labour-intensive, but extremely beneficial in terms of the support that is provided to the previously destitute person. Research has proven this approach to be successful in preventing the recurrence of destitution (Susser t al., 2003:67).

CTI may be considered as part of outside-in missions, because it focuses on efforts from outside to empower destitute people and constitutes part of the social services delivery strategies that should benefit the destitute.

4“Outside-in” missions as the empowerment of communities

The forming of social ties (Chapter 6) gives rise to community and the eventual formation of communities, which can play a significant role in the lives of destitute people; therefore the formation of communities (of care and support), and the strengthening of such existing communities should be actively pursued by helpers.
Being part of a community can benefit destitute people in a number of ways. Firstly, by creating social spaces that will prevent destitution. Such communities will, secondly, also help the destitute to heal, by providing support and a safe harbour. Thirdly, communities will also share a stronger (combined) voice for advocacy, employment negotiations and other engagements with the power structures of the day.
Therefore it becomes important not only to link the destitute to communities by the forming of social ties, but also to strengthen and develop communities themselves so that they will empower their members not to become destitute (in the process also preventing destitution); it is also vital to utilize communities to help heal destitute people.
Saleebey (1997:201) defines a community as “a dynamic whole that emerges when a group of people participate in common practices, depend on one another, make decisions together, identify themselves as part of something larger than the sum of their individual relationships, commit themselves for the long term to their own, one another’s and the group’s well-being”.
Traditionally, the word that was used for community empowerment is “development”. Development is seen as the way to empower people out of entrapment in the poverty cycle. In this sense, the United Nations in its Millennium Declaration of 2000 ((United Nations 2000:11) sums up the hopes of many in the world when it speaks of the “right to development”:

We will spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty, to which more than a billion of them are currently subjected. We are committed to making the right to development a reality for everyone and to freeing the entire human race from want

In terms of community development approaches, the intention is not to develop a model here. Rather, the focus is placed on discerning principles and applying them as part of strategies that should empower communities to become places (physical – social – economic spaces) that will sustain a way of life where people are non-destitute and can remain so.