Methods: Residents who were within 3 months of discharge volunteered and consented to participate in the study, completed a baseline interview and were randomized to either CTI-R or enhanced TAU using 1:1 random assignment stratified by sex. The majority of those who were excluded before randomization were discharged prematurely for unknown reasons. Following the baseline assessment, 60 people were randomized to either CTI-R (N=30) or TAU (N=30). Follow-up assessments were conducted at 3-, 6-, 9-, and 12-months. We used the 3-month data to estimate differences between treatment and comparison groups in housing and aftercare substance use services, we conducted regression analyses, with alpha set at .05.
Results: Participants were average age of 45 years, mostly male (57%)—proportional to the residential population—and self-identify primarily as African American, Black or Latino (78%) are mandated to treatment (59%) and reported mental health (68%) and physical health (47%) needs, as well as being homeless (81%) and unemployed (66%) before admission to RSAT. The most prevalent substances used were alcohol, heroin, crack/cocaine, and marijuana. Significant group differences in mental health severity and homelessness were found at baseline and controlled for in the regression analyses. We achieved a 3-month retention rate of 85%, 6-month retention rate of 77%, and 9-month retention rate of 65%, reflecting an overall retention rate of 76% through the 9-month assessment. The 12-month follow-up rate was lower at 55% due to COVID-19. At the 3-month follow-up, the CTI-Residential group had a significantly higher probability, by 19%, of being engaged in aftercare services post-discharge compared to the Enhanced TAU group. No significant group differences were found with respect to homelessness and substance use relapse.
Conclusion and Implications: CTI-R is a potentially useful model which is based on theory and grounded in harm reduction principles and evidence-based practices to provide reentry services for persons transitioning from RSAT. The significant impact of CTI-R on aftercare services warrants further analyses on its potential mediating role with respect to other outcomes, including homelessness and substance use relapse.