Both Pretreatment Guide for Homeless Outreach & Housing First and Homeless Narratives & Pretreatment Pathways have already gotten a number of great reviews & blurbs that I’ve posted via this page.The ideas and philosophy that these books espouse are important toward helping the homeless and other hard to engage populations that are in need.
Thanks for your consideration, Jay S. Levy, MSW, LICSW
Housing, Care and Support UK Journal vol 17, no 4 ~ Lynn Vickery‘s Book Review Excerpt
Pretreatment Guide for Homeless Outreach & Housing First
Jay S. Levy
Published by Loving Healing Press Inc.
Working with chronically homeless people is a vocation. It is challenging, at times frustrating and under recognised by housing , social work and health care and not always appreciated by the professionals working at strategic and policy levels . Occasionally a voice is heard to validate the very best of best practice and to give a theoretical underpinning to ensure that practitioners and policy makers alike can see that their actions can assist in literally recreating lives. Jay S. Levy is such a voice. In his book entitled ‘ Pretreatment Guide for Homeless Outreach & Housing First’, Levy is able to speak to those involved in front line street homelessness and say that it is possible to underpin strong processes of engagement with homeless people with a sense of purpose and humanity.
Levy uses cameos of his own encounters with homeless people to illustrate the person to person approach that centralises the other person’s sense of the encounter: if it takes a number of seemingly fleeting short ‘meetings’ over a period of time before any directional conversation takes place, then that’s just fine. The power of Levy’s approach to practice is that it is strongly goal oriented but has none of the sterile and futile language of targets and outcomes that are all too often the way in which success and justification of funding is described and measured.
The fairly short book (144 pages) is in places something of a ‘page turner’, especially when bringing to life the development of relationships with young and older people and insights gained from working with couples. These are not ‘case studies’ but rather more central to the structure and argument of the book; that there is a way of approaching homeless people prior to any treatment or intervention that maintains the integrity of all concerned and opens the way to beneficial change.
Levy uses the narrative to develop a set of frameworks that can be used in supervision, evaluation and social work/housing support training. There are no lists of sterile statistics to detract from homeless people and the possibilities of turning lives around but there are extensive references to authoritative work and theory which enables the reader, especially a busy practitioner to feel assured that there is a sound theoretical basis for Levy’s approach to compassionate practice.
In his first chapter Levy defines pretreatment as ‘ an approach that enhances safety while promoting transition to housing and /or treatment alternatives through client centred supported interventions that develop goals and motivation to create positive change’ ( p2) and one can imagine that this sort of definition sits well with policy makers and commissioners of services. However, Levy’s approach to practice enables us to see that this definition is full of substance and principled positioning. As such the person centred approach and goal focussed personal planning will find resonance with a number of initiatives in the UK, notably in the support of vulnerable needs’ groups.
But Levy’s work is most definitely centred on chronically homeless people with all the practical difficulty of itinerancy and engagement thus making planned support more challenging. Hence the emphasis on pretreatment and the need to form relationships of trust before suggesting and facilitating change that may result in finding a home and restoring the elements of purposeful life – economic security, better health, and engagement with society.
In a recent informal conversation with an experienced outreach mental health worker in the East End of London I mentioned this book and realised that I was having that kind of conversation one has when recommending a book to a book club group – ‘You really must read this book!’. What’s more I could remember enough of it to convey what it was about. The person in question jumped at the chance of the combination of encouragement and, most importantly, the sense of moving the agenda forward to produce better outcomes for all concerned.
A balanced book review should try and point out any areas of omission and defect. I am not straining to find such here; readers can find their own from their perspectives. Suffice to say that this book should be on the agenda and reading lists of education and training organisations and for all those involved in working with some of the most vulnerable people in our societies.
Book Review ~ Pretreatment Guide for Homeless Outreach & Housing First
This book is essential reading to both people new to the movement to end homelessness and folks who have been in the trenches for many years. Learn how to do effective outreach with the chronic homeless population, and the ins and outs of the Housing First model. The personal stories and the success cases will give inspiration to work even harder to help both individuals and for ending homelessness in your community.
Michael Stoops, Director of Community Organizing
National Coalition for the Homeless
Praise for Levy’s Pretreatment Guide for Homeless Outreach & Housing First
“Recently, Barbara Poppe, Executive Director for the U.S. Interagency Council on Homelessness (ICH) issued a challenge to to Continuum of Care & Ten-Year Plan Leaders:
‘Today I want to address chronic homelessness, which is
the first goal in Opening Doors. We have fewer than 1,000
days to bring the number of people experiencing chronic
homelessness to zero; every day and every minute counts.
For people living with disabilities and disabling conditions,
every day or minute spent on the streets is another day or
minute spent struggling to survive.’
As one of these leaders and someone with 25 years of providing services to the homeless population, I felt that I had the answer to Ms. Poppe’s call to action; Mr. Levy’s book! As with his earlier works, Jay Levy engages the reader with poignant narratives of this extremely vulnerable group of people then, in this latest work, chapter by chapter builds an effective framework for truly solving this decade’s old social dilemma. I strongly recommend this book to anyone truly vested in Ending Chronic Homelessness.”
Jerry Ray, Director of Homeless Services-Mental Health Association Inc. (Springfield, MA)
Pretreatment Guide for Homeless Outreach & Housing First could be a text book for a course on working with chronically homeless people. It is a hands-on manual full of caring, compassion and decency. The principles here applied to homeless people are those that should guide all helping relationships such as psychotherapy and social work. This is actually best expressed in the opening sentence of the last chapter: “A pretreatment guide based on universal principles of care has been presented and applied to Homeless Outreach and Housing First activities.” It is all evidence-based, and the author’s expertise shines through.
A really valuable aspect of this book is the level of detail in the case studies. This makes it a primer for inexperienced therapists and social workers. Equally useful is the way in which the same principles are applied in different circumstances, cumulatively adding to their understanding. This is always fresh, never boring.
As always, editing Jay Levy’s work has been an honor.
Dr. Bob Rich, M. Sc., Ph. D.
Psychologist & Editor
Member of the Australian Psychological Society
Boston Healthcare for the Homeless Review
Jay Levy has given us a magnificent gem in his book Homeless Narratives & Pretreatment Pathways: From Words to Housing. Utilizing a rich experience spanning more than two decades as a social worker on the streets and shelters of New York, Boston and Western Massachusetts, Levy has listened carefully to those living on the fringes of our society and masterfully presents his innovative approach to engagement and pretreatment. Unscripted initial approaches to this vulnerable population lay the foundation for enduring and trusting relationships, and the art and skill of these approaches are deftly analyzed. The interweaving of stories with theory and practice makes this approachable book a must for outreach workers, clinicians, administrators, policy makers and all who seek solutions to the societal tragedy of chronic homelessness.
Levy articulates a set of core principles for the initial engagement of those who are hardest to reach in our society, many of whom bear a complex burden of medical, mental health and substance abuse issues. Housing and mainstream services have been largely unavailable to these chronically homeless individuals in the past, and the importance of Levy’s approach to engagement and pretreatment has been magnified by the current federal emphasis on low-threshold supportive housing programs as a means to both end chronic homelessness and provide accessible and available health and social services.
The narrative is replete with Michael White’s “sparkling moments,” as Levy crafts stories of characters who sear the memory: Old Man Ray, the World War 2 veteran who resents the VA system and regards himself as the de facto night watchman at Port Authority; Ben who claims to be a prophet disowned in his own country, crucified by the government and enslaved by poverty finds a bridge to the mainstream services and a path to housing through the common language of religious metaphors, including redemption and forgiveness; and Andrew who has been “mentally murdered” is helped to understand his own situation and gain disability benefits through the language of trauma; among others.
These stories are deftly interwoven with theory and practice as Levy constructs his developmental model of the engagement and pretreatment process. The outreach worker strives to understand the language and the culture of each homeless individual, builds a bridge to the mainstream services, and helps those providers to understand the special circumstances of these vulnerable people. Levy bears witness to the courage of these pilgrims who wander the streets of our cities, and his poignant book is a testament to the healing power of trusting and enduring relationships.
Jim O’Connell, MD – President and Street Physician for Boston Health Care for the Homeless Program. He is nationally recognized as one of the preeminent experts on homelessness and healthcare.
Highlights from Families In Society Journal Review
Book review by W. Patrick Sullivan
The bulk of Homeless Narratives & Pretreatment Pathways: From Words to Housing details the phase of helping that often proves the most vexing when working with this population—engagement, or what Levy calls pretreatment. In surveying the practice wisdom that abounds, Levy (2010) argues “what is lacking is an overarching set of principles that captures the complexity of helping hard-to-reach populations that are reticent to accept services, but are in need of health care and housing” (p. 1–2). At the core of the approach offered here is a quest to understand the narratives of those in need; hence, Levy challenges readers to listen closely and attentively to the stories people tell of their lives. Indeed, Levy posits, “the more we bear witness to the stories of homeless survivors, the more we are convinced of the strength and endurance of the human spirit, as well as the magnificent healing power that a meaningful relationship can harness” (p. 2).
The centerpiece of Homeless Narratives & Pretreatment Pathways is the presentation of several case studies designed to demonstrate the process of pretreatment engagement and the skillful understanding and use of narrative in helping episodes. The strength of the text lies in the demonstration of the principles of common language development. As outlined here, the task for the helper is to understand the “words, values, and concepts” of the homeless, develop a common language between the outreach worker and the person, and utilize the bridge building process, which helps the potential service recipient become familiar and understand the language of the service world and vice versa (Levy, 2010, p. 57).
It is in the presentation of these case examples that the book shines the brightest. As important as the explication of the process of common language development is in the engagement phase is the consistent reaffirmation of the values and ethics that should govern all such interventions. Each vignette goes to great lengths to show how the skillful helpers tune in to the person behind the situation, diagnosis, or other aspects of their life that can be easily viewed solely through the lens of pathology. By carefully attending to the person, Levy demonstrates how difficult and overwhelming cases are finally stripped down to the most basic question of what the person wants, and how others around them can help them reach their goals. Aspects of strengths–based helping and empowerment approaches are demonstrated at every turn, and are often illustrated in the most practical and basic of interactions and interventions. One is reminded anew that oftentimes the things helpers do that look from afar to be the most simple and rudimentary are often the most important. The constancy of this message is what makes this volume particularly useful for those in the early stages of their career, particularly those who are far too eager to diagnose and treat without first listening and hearing.
Homeless Narratives & Pretreatment Pathways would serve as a useful complement to a primary text in undergraduate practice and case management classes, as well as specialized topics classes in mental health and addictions. In addition, the book could serve as a useful tool in skill-building classes, particularly those focused on assessment and basic interviewing. While experienced practitioners would likely long for more detail and depth than this volume offers, by virtue of the liberal use of case examples it is a light read. As a result, the stories and principles offered here could easily be incorporated into clinical supervision and agency workshops.
Homeless Narratives & Pretreatment Pathways
Jay S. Levy, MSW, LICSW
Loving Healing Press, Inc. (2010)
Reviewed by Charline Ratcliff for RebeccasReads (3/11)
I just finished reading “Homeless Narratives & Pretreatment Pathways: From Words to Housing” by Jay S. Levy, MSW, LICSW. Overall I found it to be a wonderful book. It is extremely well thought out plus it is laid out in an easy-to-follow and easy-to-understand manner. I liked that it was written in such a way that even those of us who don’t have a degree in Social Work can still understand it. I definitely appreciated hearing the author’s perspective because he actually has extensive first-hand experience from working on the streets and with shelters in New York City, Boston and western Massachusetts. And finally, I liked the fact that he included real experiences and shared moving stories like Old Man Ray, Tracy or Andrew in “Homeless Narratives & Pretreatment Pathways.”
“Homeless Narratives & Pretreatment Pathways” is a book that gives us a peek into the real world of homelessness. Throughout its pages Levy has deftly intertwined true story with theory and practice. He shows us how each individual person and his or her situation is different. He explains how some homeless people can, and do, suffer from untreated mental illness, addiction, and other medical conditions which ultimately lead to a steady deterioration of their health. Many of us have probably wondered at one time or another why homeless people would prefer to live on the street rather than seek help. In “Homeless Narratives & Pretreatment Pathways” Levy uses his personal experiences and stories from homeless people he has worked with during the years to help answer that question. Needless to say while I found “Homeless Narratives & Pretreatment Pathways” to be an eye-opening read; I also found its accompanying statistics to be very sobering.
All in all I would say that Levy did a fantastic job writing “Homeless Narratives & Pretreatment Pathways.” Anyone who reads this will come away with a fresh perspective and hopefully a little more respect for those who are unfortunate enough to have to live on the street. A “must read” for everyone but especially for those looking to have a career in any type of social work or outreach program.
Review by Kristine Johnson
Local author and licensed social worker Jay S. Levy has been working with the homeless populations of western Massachusetts, Boston, and New York City for the past 20 years, providing outreach and aiding in the procurement of housing for those individuals who are the most difficult to reach and help; individuals who suffer from mental and/or medical illness, addiction, and those who have been chronically homeless for years.
Levy’s new book, Homeless Narratives and Pretreatment Pathways lays out a thoroughly researched and developed approach for intervention— one that supports housing individuals as rapidly as possible without requiring participation in support services as a prerequisite for getting housed. Of critical importance is the ongoing dialogue between the outreach worker and the homeless individual. For various reasons, opening such dialogue is often extremely problematic when working with those suffering from addiction and mental illness; those who are, at times understandably, wary of any such attempts at connection and offers for assistance.
The book draws upon Levy’s wealth of experience in the field in the form of well-explained narratives and case studies which provide concrete examples of connection and relationship building between outreach workers and homeless individuals, Creating trust that ultimately results in the homeless individual becoming receptive to offers of aid
This easy to follow field guide for outreach workers is an engaging read, with colorful characters and concrete techniques which can be used and applied by those working in any of the social service fields. (Reprinted With Permission)
– Reviews & Blurbs
|By||Reader Views “www.readerviews.com” (Austin, Texas) – See all my reviews|
Reviewed by Carol Hoyer, PhD, for Reader Views (09/10)
This is one of the best guides I have read about working with the underserved and homeless. I wonder why all cities don’t put it into place. Quite frankly, I get tired of hearing professionals say they are overworked and underpaid. How we approach our homeless can definitely make a difference. Sometimes it’s not in the techniques, but in the attitude of the case manager.
As the author says “It was equally clear that many of the most severely impaired were unwilling to `accept’ their illness under the terms and conditions imposed by housing programs with strict eligibility requirements.” In addition, this is the life the individuals live regardless of we like it or not, or point fingers. Change is very hard for them. When someone gets into the homeless individuals’ face and starts spouting what they should do, naturally they are going to back off and you may lose them forever.
The author discusses two types of the underserved. Those who live under bridges and in the woods who would come in occasionally to get help. These individuals are often not treated for their mental illness and/or substances abuse and had serious medical problems. The other group was those who are high profile. These individuals have difficulty in homeless shelters, have conflicting behaviors with what society feels is “normal.” It seems as if we cannot come up with a term that will describe chronic homelessness.
An important point the author made was regarding pretreatment. Whenever anyone approaches the homeless on the street or in the shelter it must be made carefully, not too quickly and with compassion and understanding. They must be able to see how we interact with others in a shelter or on the street and take little steps. Pretreatment is important in safety and enhancements, from painful bleeding feet to getting a warm winter coat and shoes.
Throughout the book, the author describes in detail homeless individuals he or his organization has come into contact with. It really gives you a look at how these individuals do not trust the government or anyone in power, regardless of their reasoning. This is a process that takes time; it is not an overnight cure. Trust is very important, along with speaking the same language the client does. Client-centered work is also very important- it’s not what we want, but what the client sees as a need at any given time.
Overall, “Homeless Narratives & Pretreatment Pathways” was very enlightening and full of compassion and caring. You can tell the author, along with others, has changed the direction to working with the homeless. Anyone in the helping field will do a great disservice to themselves if they do not read this book.
Australian Editor & Psychologist Review
This book is a very impressive guide to people working in any helping field that involves interacting with clients who refuse to admit having a problem. Jay’s experience is with working with homeless people who refuse services because of complex mental health or addiction problems, but his respectful attitude will work in other fields as well, as I can attest from my personal experience as a psychologist.
The information is presented through a number of very clear case studies that immediately bring the material to life. I think that any intelligent reader will be able to apply Jay’s approach – and it is well advised to do so. I am going to recommend this book to Australians working with homeless people.
Dr. Bob Rich, M. Sc., Ph. D.
Psychologist & Editor
Member of the Australian Psychological Society
Excerpt From The Forward of HNPP
“The author, Jay S. Levy, provides us with illuminating client narratives, which build bridges into the world of homelessness, trauma, mental illness, and substance abuse, while sharing the “pretreatment pathways” he has successfully employed in his work. Homeless Narratives & Pretreatment Pathways: From Words to Housing gives homeless outreach clinicians and workers easy access to the author’s well-developed approach for the “journey” with homeless persons transitioning from the streets and shelters to stabilization in housing.”
David W. Havens, M.Ed.
Program Director, Homeless Outreach/Safe Havens Programs
Mental Health Association, Inc.
Adjunct Professor, School of Human Services, Springfield College
Blurbs from the field of Homeless Services
“Jay Levy’s experience in working on engagement strategies and developing a “common language” with the untreated mentally ill homeless population should be required reading for anyone who wishes to work in the field. As we move from a “shelter-based” strategy to a “housing first” model, Jay’s work has become even more critical to ending chronic homelessness with the mentally ill on our streets and in the emergency shelter system nationwide.”
Larry Gottlieb, MSW, MPA
Director of Homeless and Outreach Services
Eliot Community Human Services
NHCHC Co-Chairman of Education Committee
“As a provider of outreach and housing to the most difficult-to-engage homeless individuals I’ve been searching for more material that directly addresses this challenging work. After 25 years of providing homeless services, I’ve finally come across a book that clearly articulates my experience from outreach to housing stabilization. Homeless Narratives & Pretreatment Pathways so well captures the essence of engagement, and the successful outcomes that follow, that any professional in the field will find this enjoyable reading. I also highly recommend this book to be used in both the orientation and supervision of new outreach staff.”
Director of Homeless Services
Mental Health Association, Inc.
It gave me pause to read Jay Levy’s words “For too long, we have viewed successful outreach workers as freelance artists who are inspired to help the downtrodden.” Beyond my pause is my conviction that if the work can be taught, this artful presentation would be the place to begin.
Richard Hendrick, MSW, LICSW
Outreach Social Worker, Author of Not For Nuttin’: A Journey with “some folks without homes” and me.
Homeless Outreach & Housing First: Lessons Learned
Jay S. Levy
Loving Healing Press
5145 Pontiac Trail
Ann Arbor, MI 48105
9781615991365, $8.95, www.jayslevy.com
Social Issues Shelf-
A home is something all too many take for granted. “Homeless Outreach & Housing First” is a discussion of a program that tries to help the homeless find homes, and get them on the first step to climbing out of their economic hole. With plenty to ponder on the process and its noble goal, “Homeless Outreach & Housing First” is a fine pick that shouldn’t be overlooked for community library social issues collections.
-Midwest Book Review – Library Bookwatch
Housing First… Pure and Simple
Jay Levy has written a straight forward, well informed treastise on a topic that cries out for new and innovative solutions. Jay makes it clear that there are no quick fixes to solving the homelessness problem. Whether you are a worker in the field, or citizen wanting to better understand the complexities of homelessness you will be the better for having read Jay’s newest book.
-David Modzelewski, Mental Health Association, Inc.