Tag Archives: Promising Strategies Series


Promising Strategies Series: Vulnerability Assessment Tool (VAT)

Our Promising Strategies Series blog entries are intended to offer a brief overview on specific approaches to end homelessness. We will post links to external sites where you can find more in-depth information.

Representatives from DESC out of Seattle, Wash., were in Nashville from April 24-26 to train a group of service providers on the Vulnerability Assessment Tool (VAT) that will further help determine who in our community is most vulnerable and in dire need of housing.

DESC developed the VAT about 10 years ago and applied it at its main shelter to determine who needs a bed for the night most urgently. The tool allows programs to give priority to people who are extremely vulnerable if left to fend for themselves.

The VAT rates a person’s level of functioning and health and includes other specific characteristics to determine individual safety. More specifically, the VAT examines 10 different areas to measure vulnerability:

  1. Survival Skills;
  2. Basic Needs;
  3. Indicated Mortality Risks;
  4. Medical Risks;
  5. Organization/Orientation;
  6. Mental Health;
  7. Substance Use;
  8. Communication;
  9. Social Behaviors; and
  10. Homelessness.

Click the following link for an introduction to the Vulnerability Assessment Tool.

DESC has a close working relationship with the University of Washington and a research evaluation conducted on the VAT in 2010 concluded that the tool holds “strong properties of both reliability and validity.”

We are honored that DESC representatives travelled to Nashville to train a select group of outreach workers and service providers in utilizing the VAT properly.

How’s Nashville plans to use the VAT in conjunction with the Vulnerability Index (VI). The VAT goes into more details while the VI mostly relies on self-reporting. Utilizing the VAT will give us an extra layer to help determine who among our neighbors living in the streets and shelters are most vulnerable. We plan to prioritize housing, starting with the most vulnerable and chronically homeless individuals in our community.

About DESC: The Downtown Emergency Service Center (DESC) is a nonprofit organization based in Seattle that works to end the homelessness of vulnerable people, particularly those living with serious mental or addictive illnesses.  Follow the link to read DESC’s full mission statement.


Promising Strategies Series: Critical Time Intervention


Our Promising Strategies Series blog entries are intended to offer a brief overview on specific approaches to end homelessness. We will post links to external sites where you can find more in-depth information.

Critical Time Intervention (CTI) is a time-limited case management model that focuses on assisting a person transitioning from a shelter, hospital, prison, or other institution into a permanent living situation. The program is structured in three phases each lasting about three months.

The following table is copied from an online paper describing CTI: (http://www.criticaltime.org/wp-content/uploads/2009/04/cti-handout4.pdf)

Phase Transition Try-Out Transfer of Care
 Timing  Months 1-3 Months 4-7 Months 8-9
 Purpose Provide Specialized support &   implement transition plan Facilitate and test client’s   problem-solving skill Terminate CTI services with support   network safely in place
  •   CTI   worker makes home visits
  •   Accompanies   clients to community providers
  •   Meets   with caregivers when necessary
  •   Gives   support and advice to client an d caregivers
  • Mediates conflicts between client and caregivers
  •   CTI   worker observes operation of support network
  •   Helps to   modify network as necessary
  •   CTI   worker reaffirms roles of support network members
  •   Develops   and begins to set in motion plan for long-term goals (e.g. employment,   education, family reunification)
  •   Holds   party/meetings to symbolize transfer of care

CTI was developed in the early 1990s by Columbia University and New York State Psychiatric Institute to assist transition people with mental illness from institutional settings to community living.

The model works in two ways:

  1. CTI offers individualized support to ease the transition from an institution to permanent housing; and
  2. It helps develop and strengthen individual’s long-term relationships with support networks such as family, friends, and community service.

The goal is to prepare people to access support services without the intensive care of a case manager.

For a more thorough overview of CTI, visit the U.S. Interagency Council on Homelessness’ Solutions Database. (http://www.usich.gov/usich_resources/solutions/explore/critical_time_intervention_cti/)

Additional resources can be found at the following links:

Critical Time Intervention (http://www.criticaltime.org/)

SAMHSA’s National Registry of Evidence-based Programs and Practices (http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=125)

Critical Time Intervention Training and Evaluation from the Center for Social Innovation (http://www.center4si.com/projects/projects.cfm?project=f0fa1046-ba1d-485d-ab3f-24e018e3e694)