: Jay S. Levy, Louise Levy
: Pretreatment Across Multiple Fields of Practice Trauma Informed Approach to Homelessness and Beyond
: Loving Healing Press
: 9781615998593
: 1
: CHF 8.20
:
: Sozialpädagogik, Soziale Arbeit
: English
: 228
: DRM
: PC/MAC/eReader/Tablet
: ePUB

'Jay and Louise Levy and their co-authors have distilled years of diverse experience serving people with complex psychological and physical needs into a much-needed roadmap for providers. This book clearly outlines working principles that guide practitioners in the art of building authentic and effective working partnerships with people experiencing homelessness and other traumas, while minimizing re-traumatization and creating psychological safety. Carefully chosen case studies beautifully illustrate how these principles can be put into practice in a variety of settings--from street outreach to shelters to special education classrooms--and are attentive to the impact of racism and other forms of oppression.'
-- Kiko Malin, MPH, MSW, Public Health Director, Amherst, Massachusetts
'As a representative of the Street Medicine Institute, and more importantly, the global street medicine movement, Jay's work is a beacon not just to light the path we are on, but to guide us towards a better place.'
-- Jim Withers, MD, Medical Director and Founder of Pittsburgh Mercy's Operation Safety Net, Medical Director and Founder of the Street Medicine Institute
'As Levy, Conolly, and others argue in this important book, the concept of Pre-treatment Therapy is of major applicability way beyond the field of homelessness: its ideas and concepts should be core reading for psychologists and psychiatrists and indeed anybody hoping to work with people affected by chronic experiences of trauma in a psychologically informed way.'
-- Dr Peter Cockersell, DPsych, Psychoanalytic Psychotherapist, Chief Executive of Community Housing and Therapy
From Loving Healing Press

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Introducing Pretreatment: Outreach Counseling for People with Significant Trauma& Loss
Jay S. Levy

If we could look into each other’s hearts and understand the unique challenges each of us faces, I think we would treat each other much more gently, with more love, patience, tolerance, and care.

Marvin J. Ashton (1992)

Far too many people are desperately in need and yet are afraid to hope. The most vulnerable among us are often not actively seeking help and may even be pre-contemplative3 of their own complex-multiple needs. This is an understandable and protective stance to a significant history of trauma and loss that is often compounded by negative experiences with human service workers and systems of care (toxic help4). Some have experienced so many unkept promises or perceived personal failures in addition to the loss of critical supportive relationships that they reside in a perpetual state of learned helplessness.

Since the late 1980s, I found this to be common among people who had experienced long-term homelessness. On a basic level we were failing to reach out to those who were most in need. There was a clear calling for a more effective and impactful outreach counseling practice that could not only facilitate access to affordable housing, but also recovery options to address the vestiges of significant trauma and loss.

I first pioneered “Pretreatment” as an approach to help people without homes who presented with complex trauma issues in an article published by theFamilies in Society journal, entitled “Homeless Outreach: On the Road to Pretreatment Alternatives” (Levy, 2000). This was the outgrowth of my witnessing too many people being ignored by a treatment-biased culture. People who were continually refused services because they were not raising their hands and actively requesting help for healthcare inclusive of mental health and/or addiction issues. In response to this dilemma, a Pretreatment philosophy was developed from an outreach perspective.

Over the past several years, applications of Pretreatment have spread, aiding a variety of programs and staff to reach those who were often deemed “too high risk,” “non-compliant,” “beyond service capabilities,” “ineligible,” or “not ready” to partake in services. The fields of practice have ranged from outreach, street medicine, and housing support to clinical services that address trauma, as well as education to better serve those with complex multiple needs.

What is it about Pretreatment that allows for such great flexibility across multiple fields of practice? The answer is rooted in its four basic tenets of care (Levy, 2013):

•The initial task is to literally and figuratively get where the person is at.

•Our interventions are informed by how our words and actions resonate in the person’s world.

•We foster a trusting relationship that upholds client autonomy as the foundation of our work, while utilizing common language construction as our main tool for facilitating productive dialogue.

•We instill a sense of hope and possibility for positive change.

I think that one can see from the outset how these basic tenets have universal appeal for human services, as most if not all human services can be relationship-driven. In fact, a Pretreatment model is primarily based on the research that has demonstrated the importance of person-centered and goal-focused work.

What is Pretreatment?

The term “Pretreatment” (Levy, 2000, pp. 360-368; Levy, 2010, pp. 13-16) initially appeared as “Pretreatment Variables” through research that predicted successful outcomes for addiction and recovery treatment approaches (Joe et al., 1998, p. 1177; Miller& Rollnick 1991, pp. 5-29; Salloum et al., 1998, p.35). Psychologist and researcher Bruce Wampold (2001) took this a step further by conducting a meta-analysis of pretreatment variables on the success of different counseling methods for addressing menta