The Ministry of the First Encounter: Radical Hospitality as Pretreatment for the Marginalized

Introduction: The Sacred Threshold – Welcoming the Wounded Before Treatment Begins
Part I: The Clinical Foundation – Understanding the Pretreatment Phase
1. The Power of the First “Yes”: Defining Pretreatment Change
2. A Framework for Engagement: Jay Levy’s Five Principles for Outreach
Part II: The Theological Imperative – A Christ-Centered Foundation for Service
1. “I Was a Stranger and You Invited Me In”: The Theology of Radical Hospitality
2. Washing the Feet of the Forgotten: The Model of Servant Leadership
Part III: The Synthesis – Hospitality as Pretreatment in Action
Conclusion: The Ministry of the First Step
1. Works cited

Introduction: The Sacred Threshold – Welcoming the Wounded Before Treatment Begins

For Christian social service organizations, the initial encounter with a person in crisis is not merely an administrative event; it is a sacred opportunity for ministry. The front door, the waiting room, the first phone call—these are theological spaces. They represent a threshold where the love and character of God are first made tangible to those who are hurting, often after they have been repeatedly rejected, stigmatized, and dehumanized by the world.1 This first moment is a profound test of an organization’s mission, echoing the words of Christ: “I was a stranger and you invited me in” (Matthew 25:35). The welcome offered at this threshold can either reinforce a lifetime of exclusion or begin the process of healing.

This paper advances a central thesis: the clinical concept of “pretreatment” finds its most potent and effective expression through the theological virtues of Radical Hospitality and Servant Leadership. This integrated approach transforms client service from a secular business practice into a powerful ministry of engagement and restoration. For populations marked by homelessness, PTSD, and mental illness—individuals whose lives are often defined by trauma and mistrust—this hospitality-first model is not merely an enhancement. It is a clinical and spiritual prerequisite for any subsequent therapeutic intervention to succeed.

This report will first establish the clinical foundations of the pretreatment phase, exploring the power of recognizing client-initiated change and the evidence-based principles for engaging hard-to-reach populations. It will then delve into the theological imperatives of radical hospitality and servant leadership as modeled by Christ. Finally, it will synthesize these clinical and theological frameworks into a practical, actionable model for ministry, demonstrating how a Christ-centered welcome can overcome profound barriers to care and lay the groundwork for lasting transformation.

Part I: The Clinical Foundation – Understanding the Pretreatment Phase

The Power of the First “Yes”: Defining Pretreatment Change

In clinical social work and psychotherapy, “pretreatment” refers to the critical period between a client’s initial contact with an organization—such as a phone call to schedule an appointment—and the beginning of formal therapeutic sessions.3 Historically, this phase was often overlooked, with the assumption that meaningful change begins only when a clinician starts applying formal interventions.4 However, a growing body of research challenges this notion, revealing that significant, positive behavioral shifts, known as “pretreatment change,” frequently occur within this window.3

Studies focusing on individuals with substance use disorders (SUDs), for example, consistently show that a substantial number of clients reduce their substance consumption or increase their days of abstinence after making the decision to seek help but before their first official appointment.3 In one study, 44 percent of clients demonstrated a reduction in alcohol consumption during the month prior to their first session.3 This phenomenon is not just a statistical curiosity; it is a powerful predictor of future success. Greater pretreatment reductions in substance use have been shown to correlate with better treatment outcomes at both three-month and twelve-month follow-ups.4

This evidence fundamentally reframes the role of the practitioner and the nature of the first encounter. The client is not a passive recipient of care but an active agent who has already initiated their own change process.4 The decision to reach out is, in itself, a monumental step. This aligns perfectly with the core tenets of strengths-based social work, which posits that every individual possesses inherent strengths and resources that can be mobilized for change.6 Rather than focusing on deficits and pathologies, a strengths-based approach seeks to identify, honor, and build upon the client’s existing capacities and self-efficacy.3 The practitioner’s role, therefore, is not to initiate change but to recognize, affirm, and enhance the change that is already underway.3 This shifts the power dynamic inherent in many service models. Where a traditional approach might inadvertently position the provider as the expert with the solution and the client as the problem to be fixed, the pretreatment change model validates the client’s agency.7 This is more than sound clinical practice; it is a theological affirmation. It recognizes the Imago Dei—the image of God—within the client, honoring their capacity, resilience, and courage. The organization’s first task is not to “fix” but to witness and affirm the work that God, through the client’s own will, has already begun.

A Framework for Engagement: Jay Levy’s Five Principles for Outreach

While the concept of pretreatment change is broadly applicable, its principles have been specifically adapted for engaging with populations who are often resistant to or alienated from traditional services, such as individuals experiencing homelessness. Social worker Jay Levy developed a five-principle framework for outreach that provides an essential, evidence-informed roadmap for practitioners during this critical engagement phase.8 These principles serve as the clinical gold standard for establishing the trust necessary for any further intervention.

Promoting Safety: This is the foundational principle. For a person experiencing homelessness, life is a state of constant threat and hypervigilance.9 Before any meaningful interaction can occur, the worker must establish an environment of both physical and emotional safety. This means meeting immediate needs for security and demonstrating through action that the space and the interaction are safe.8
Forming a Relationship: Pretreatment prioritizes the person over the process. The initial focus must be on building rapport and a trusting relationship, not on intake forms or assessments.8 This requires patience, consistency, and genuine human connection. The relationship itself becomes the primary vehicle for change.10
Developing a Common Language: This principle calls for the worker to relinquish the “expert” role and collaborate with the client to find a shared way of describing their situation, needs, and goals.8 It means listening to and respecting the client’s narrative and using their language, rather than imposing clinical jargon or agency-defined categories. This honors the client’s perspective and empowers them as a partner in the process.11
Facilitating and Supporting Change: Only after a foundation of safety, relationship, and shared understanding has been established can the worker begin to gently support the client’s self-identified goals for change.8 The change is client-directed, with the worker acting as a facilitator and resource, not a director.
Taking into Account Cultural and ‘Ecological’ Considerations: This principle demands an acute awareness of the client’s world.8 This includes their personal culture and beliefs, but also the unique “ecology” of street life—the social networks, survival strategies, and daily realities that shape their experience. Effective engagement requires the worker to understand and respect this context rather than judging it.

These five principles provide the practical structure upon which a robust, Christ-centered model of service can be built. They operationalize the initial phase of engagement, ensuring that it is client-centered, respectful, and clinically sound.

Part II: The Theological Imperative – A Christ-Centered Foundation for Service

“I Was a Stranger and You Invited Me In”: The Theology of Radical Hospitality

For a Christian organization, the mandate to welcome others is not a matter of good customer service; it is a core theological imperative. The concept of “radical hospitality” defines this mandate, differentiating it from mere friendliness or politeness. Radical means “drastically different from ordinary practice”.12 It is a proactive, justice-oriented practice that intentionally seeks out those on the margins—people who may consider themselves “beyond the reach of organized religion”.13 It is about offering the “utmost of themselves, their creativity, their abilities, and their energy to offer the gracious invitation and reception of Christ to others”.12

The biblical foundation for this practice is rooted in passages like Matthew 25, where Jesus explicitly identifies himself with the hungry, the thirsty, the naked, and the stranger.15 This theology is powerfully articulated in the 6th-century Rule of St. Benedict, which commands that all guests “are to be welcomed as Christ”.16 This simple directive fundamentally shifts the posture of the host. The interaction is no longer one of charity, where the powerful bestow aid upon the powerless. Instead, it becomes an act of humility and adoration, recognizing and honoring the very presence of Christ in the person seeking help.16 This perspective dissolves hierarchies and demands that every person, regardless of their station or struggle, be treated with the utmost dignity and respect.

A key element of radical hospitality is its unconditional nature.16 It welcomes everyone without demanding they change first, meet certain criteria, or conform to the organization’s culture. It creates a safe and inclusive space where individuals can be their authentic selves, knowing they are valued for who they are, not for who they might become.17 Practically, this is expressed through intentional actions that exceed expectations.19 These include the simple but profound acts of truly noticing the individual as a unique person, offering them undivided personal attention, and creating an encounter that makes them feel seen, heard, and valued in a world that has rendered them invisible.1

Washing the Feet of the Forgotten: The Model of Servant Leadership

If radical hospitality is the theological posture of welcome, servant leadership is the ethical action that makes that welcome tangible, healing, and empowering. The two are inextricably linked. One cannot exist authentically without the other in a Christ-centered ministry. Hospitality without the action of service is merely a pleasant but empty sentiment. Service without the heart of hospitality can become paternalistic, transactional, or even coercive. Radical hospitality answers the “Why?” and “Who?” of ministry (We welcome because we are welcoming Christ himself). Servant leadership answers the “How?” (We welcome by humbly serving, prioritizing, and empowering).

The ultimate model for servant leadership is Jesus Christ, who declared that he “did not come to be served, but to serve, and to give his life as a ransom for many” (Mark 10:45).20 This model is built on several core principles:

Humility: Servant leadership fundamentally inverts the world’s power structures. Jesus taught that true greatness is found not in authority or position, but in service: “Whoever wants to become great among you must be your servant” (Matthew 20:26–28).22 This principle was most dramatically illustrated when Jesus, the Lord and Teacher, knelt and washed his disciples’ feet—a task reserved for the lowest of servants.20 This act demonstrates that true leadership in God’s kingdom flows from a posture of humility.
Compassion: Jesus’s service was motivated by a deep, empathetic compassion for the suffering of others. He “had compassion on them, because they were harassed and helpless, like sheep without a shepherd” (Matthew 9:36).20 This was not a passive feeling but an active concern that led him to heal the sick, feed the hungry, and befriend social outcasts.
Prioritizing Others: Servant leadership requires genuinely putting the needs and interests of those being served above one’s own agenda or the organization’s convenience. As the Apostle Paul exhorts, “in humility value others above yourselves, not looking to your own interests but each of you to the interests of the others” (Philippians 2:3–4).20 This involves a conscious investment in the development and well-being of others for the sake of the common good.24
Empowerment: A servant leader does not use their position to control or create dependency. Instead, they seek to empower others, building them up and creating opportunities for them to use their own gifts, make their own choices, and succeed on their own terms.20 The goal is to enhance the client’s capacity and self-determination, restoring the agency that has so often been stripped away by their circumstances.10

Part III: The Synthesis – Hospitality as Pretreatment in Action

Overcoming the Wall of Mistrust: Why Hospitality is the Only Key

To understand why a hospitality-driven model is not just preferable but essential, one must first grasp the profound barriers to care faced by individuals experiencing homelessness, severe mental illness, and PTSD. Homelessness is not merely the absence of shelter; it is a profoundly traumatic event that can, in itself, cause or exacerbate conditions like PTSD.9 The daily struggle for survival—finding food, staying safe, enduring the elements—erodes coping mechanisms and creates a state of chronic stress and trauma.27

Compounding this trauma is a pervasive social stigma. Public perception is often shaped by harmful and inaccurate stereotypes: that people experiencing homelessness are lazy, dangerous, addicted, or have chosen their situation.29 This stigma is not an abstract social issue; it is experienced directly and painfully in the very places where help is supposed to be found. Individuals report being treated with disrespect and a lack of compassion in healthcare and social service settings, feeling judged, dehumanized, and invisible.1 These repeated negative experiences, often layered over a lifetime of systemic failures and broken promises, cultivate a deep and entirely justified “medical mistrust” and a general suspicion of service systems.1 For many, mistrust becomes a necessary “survival skill”.30

Given this reality, traditional, impersonal, and bureaucratic intake processes are almost destined to fail. An approach that begins with a clipboard, a list of requirements, and a focus on deficits immediately triggers this history of trauma and mistrust. A person who has been consistently dehumanized will not engage with a process that feels dehumanizing. Therefore, the unconditional, person-centered welcome of radical hospitality is not a “soft skill” or an optional extra. It is a necessary clinical intervention required to breach this wall of mistrust. It is the only way to create the foundational safety and trust required for engagement, assessment, and treatment to even begin.

From Intake Form to Sacred Encounter: A Practical, Integrated Model

The synthesis of clinical pretreatment principles and theological virtues creates a powerful, practical model for the first encounter. It transforms the interaction from a procedural intake into a sacred encounter. Instead of an opening like, “I need you to fill this out,” the interaction begins with an act of hospitality: “Welcome, I’m so glad you’re here. Can I get you some water or coffee? My name is Sarah, it’s good to meet you.” This simple shift immediately embodies the principles of noticing the person 19, promoting safety by offering care without preconditions 8, and beginning the process of forming a relationship.8 The following framework provides a guide for integrating these concepts into every initial interaction.

Table 1: Bridging Theory and Practice: A Framework for Hospitable Pretreatment

Jay Levy’s Pretreatment Principle	Radical Hospitality/Servant Leadership Principle	Practical Application in a Christian Social Service Setting
1. Promoting Safety	Unconditional Welcome & Seeing Christ in the Other: Creating a space where the person’s inherent dignity is honored before anything else.16	Offer immediate, non-contingent care: a warm drink, a comfortable chair, a safe place to rest. Use welcoming, non-judgmental language. Ensure the physical environment is clean, calm, and respectful. Meet basic needs without requiring paperwork or compliance first.
2. Forming a Relationship	Humility, Compassion & Personal Attention: Prioritizing the person over the process.19	Learn and use the person’s name. Practice active, empathetic listening; put down the clipboard and make eye contact. Ask about them as a person, not just about their problems. Share your own name. Be authentic and genuine.
3. Developing a Common Language	Selflessness & Empowering Others: Relinquishing the “expert” role and honoring the client’s narrative.11	Ask open-ended questions: “What brought you here today?” “What are you hoping for?” “How do you see things?” Avoid clinical jargon. Allow the client to define their situation and goals in their own words. Collaborate on identifying the next step, ensuring they feel ownership.
4. Facilitating & Supporting Change	Strengths-Based Service & Investing in Others: Recognizing and affirming the client’s agency and resilience.5	Actively listen for evidence of “pretreatment change” and affirm it: “It took a lot of courage to come here today. You’ve already taken a huge step.” Focus on their strengths and past successes. Connect them to resources they identify as helpful, not what the agency dictates.
5. Cultural & Ecological Considerations	Justice & Accompanied Suffering: Understanding the systemic context of their struggle and walking with them in it.13	Educate yourself about the realities of street life, trauma, and the systems that create homelessness. Advocate on their behalf against injustices. Build a long-term, reciprocal relationship that goes beyond a single transaction. Be a consistent, trustworthy presence.

Case Studies in Action: The Evolution of Gospel Rescue Missions

This integrated model is not merely theoretical; it is being put into practice by innovative Christian organizations, particularly within gospel rescue missions that are moving away from high-barrier, conditional charity toward low-barrier, hospitality-focused service.35

Historically, many missions operated on a transactional “sing-for-your-supper” model, where receiving a meal or a bed was contingent on attending a mandatory worship service.35 While well-intentioned, this approach often failed to address the deep-seated mistrust many individuals felt toward institutions. In contrast, newer models embody the principles of hospitable pretreatment by prioritizing trust-building and unconditional care.

A prime example of this evolution is the Springs Rescue Mission in Colorado Springs.35 The mission operates a tiered program that begins with a “low barrier” Relief Shelter, offering a warm bed and a meal with minimal rules: don’t fight, don’t verbally abuse staff, and don’t use or sell drugs on-site.35 This approach establishes immediate safety and care without preconditions. Crucially, the mission’s leadership understands that trust must be earned. CEO Jack Briggs notes that many homeless people “live in a world where no one keeps a promise,” so the mission focuses on building trust through concrete, reliable actions.35 For instance, when a resident hands over their clothes to be washed, they always get them back clean—a simple, consistent act of service that communicates care and dependability more powerfully than words.35

This philosophy is captured by Joel Siebersma, the mission’s senior director, who states, “Our faith is why we do what we do, but faith is never required of others to receive basic relief services”.35 This marks a profound shift. The mission’s posture is one of servant leadership, where their role is to “help in the project, not own it,” affirming that “it’s God’s job to change people”.35 By offering hospitality first, they create the safety and trust essential for the pretreatment phase to succeed, allowing individuals to then choose to engage with further services, such as health checkups and vocational training, through an incentive-based system.35

Conclusion: The Ministry of the First Step

For Christian social service organizations, the work of engaging individuals grappling with homelessness, trauma, and mental illness must begin long before the first formal treatment plan is written. Effective pretreatment for these populations is a ministry, one deeply rooted in the theological virtues of radical hospitality and servant leadership. A purely clinical, procedural, or transactional approach is insufficient to overcome the profound barriers of stigma and deeply ingrained mistrust that these individuals carry. The data on pretreatment change confirms that clients are already agents of their own recovery; the theological mandate of hospitality demands that we honor that agency by receiving them as we would receive Christ himself.

This calls for a paradigm shift. Every first encounter must be reframed—not as an administrative hurdle, an assessment of deficits, or a moment of crisis management, but as a sacred opportunity. It is the chance to be the first tangible sign of God’s unconditional love, grace, and respect in someone’s life. The first step a client takes through the door is an act of immense courage. The ministry of pretreatment is about ensuring that this step is met by the organization’s own first step toward them—an intentional act of hospitality that honors their dignity, begins to heal the wounds of exclusion, and creates a foundation of trust upon which all future work can be built.

This report was generated by Google Gemini 2.5 Deep Research using the prompt:
“You are a professor at City Vision University teaching a course in Customer/Client Service, Radical Hospitality & Servant Leadership. Write a paper for those working at Christian social service organizations on the concept of pretreatment for those dealing with homelessness, PTSD and/or mental illness. Explain how radical hospitality and effective customer (or client) service is essential to the pretreatment of these individuals. Use a Gospel Rescue Mission as a Case Study”.
It was reviewed by Dr. Andrew Sears for accuracy.

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