Homeless narratives & pretreatment pathways : from words to housing

Jay S. Levy, an outreach clinician who worked in New York City and Boston areas shares his precious and result oriented experiences with homeless people in this book. His book will guide professionals on practice and will add great experience for their field. In 2005, the fruits of the hard work became mature and a program called 'the REACH Housing First Program' was established with the support of Boston Area Commonwealth to reach the under-served population by changing the eligibility criteria. And the author of the book shares this great experience with readers who will highly benefit for their sector. Engagement strategies and development of a common language are key topics to read. These experiences are immeasurable with time or money,a highly reccommended book for the people who work with homeless people.

“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.”
Jim O'Connell, MD, President and
Street Physician, Boston Healthcare for the Homeless Program
Editor, Manual of Communicable Diseases in Shelters

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.