Open Access Study protocol

The effectiveness of critical time intervention for abused women and homeless people leaving Dutch shelters: study protocol of two randomised controlled trials

Danielle AM Lako1, Renée de Vet1, Mariëlle D Beijersbergen1, Daniel B Herman2, Albert M van Hemert3 and Judith RLM Wolf1*

Author Affiliations

1 Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Geert Grooteplein 21, Nijmegen, The Netherlands

2 Silberman School of Social Work, Hunter College, 2180 Third Avenue, New York, NY, USA

3 Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, Leiden, The Netherlands

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BMC Public Health 2013, 13:555  doi:10.1186/1471-2458-13-555

Published: 6 June 2013



One of the main priorities of Dutch organisations providing shelter services is to develop evidence-based interventions in the care for abused women and homeless people. To date, most of these organisations have not used specific intervention models and the interventions which have been implemented rarely have an empirical and theoretical foundation. The present studies aim to examine the effectiveness of critical time intervention (CTI) for abused women and homeless people.


In two multi-centre randomised controlled trials we investigate whether CTI, a time-limited (nine month) outreach intervention, is more effective than care-as-usual for abused women and homeless people making the transition from shelter facilities to supported or independent housing. Participants were recruited in 19 women’s shelter facilities and 22 homeless shelter facilities across The Netherlands and randomly allocated to the intervention group (CTI) or the control group (care-as-usual). They were interviewed four times in nine months: once before leaving the shelter, and then at three, six and nine months after leaving the shelter. Quality of life (primary outcome for abused women) and recurrent loss of housing (primary outcome for homeless people) as well as secondary outcomes (e.g. care needs, self-esteem, loneliness, social support, substance use, psychological distress and service use) were assessed during the interviews. In addition, the model integrity of CTI was investigated during the data collection period.


Based on international research CTI is expected to be an appropriate intervention for clients making the transition from institutional to community living. If CTI proves to be effective for abused women and homeless people, shelter services could include this case management model in their professional standards and improve the (quality of) services for clients.

Trial registration

NTR3463 and NTR3425

Critical time intervention; RCT; Intimate partner violence; Homelessness; Shelters