MAP shows the way
At Boston’s St. Francis House, the focus is on jobs, not group therapy
January 18, 2011
"damn, I was doing so good!” Gerry exclaims as he buries his 30-something bald head in his hands. “Then he had to ask that question.”
Gerry is one of eight people seated around a long, worn Formica table on the fourth floor of downtown Boston’s St. Francis House. They are looking at a big-screen TV, critiquing each other’s mock job interviews done a few days earlier. What threw Gerry for a loop was the interviewer’s question: “I see there’s a lengthy gap in your work history. Do you mind if I do a CORI search on you?”
Group member Angela describes the interviewer’s question about searching the state Criminal Offender Report Information system as “one big, fat sucker punch.” Everyone at the table nods in agreement.
Gerry asks, “Whatever happened to the thing about paying your dues?”
In sync, with a tone far from enthusiastic, the group says: “Prove it.”
Prison, homelessness, addiction, or some combination of all three is what brings people to the St. Francis House’s Moving Ahead Program, known simply as MAP. The difference between MAP and other recovery and re-entry programs is deceptively pragmatic. MAP believes the best way to help people is to get them a job; the soul-searching intent of all-day group-therapies can get irrelevant fast when someone is unemployed and the rent is due.
Class instructor Artie Garroni-Rounds hops to his feet. “Remember those bridge words.” He sweeps his arm behind him, toward the blackboard packed with lists. “C’mon guys, prove yourselves.” He points to the words scrawled in chalk beneath Reality and CORI. “Use the bridges—but, until, however, although, since, then—and give me some responses to ‘I see a large gap in your work history.’”
Steve offers: “I was a drunk living on the streets, but I’m not now.”
“Too detailed,” says Artie.
Gerry tentatively raises his hand. “That was when I got into trouble 15 years ago. Since then, a lot has changed.”
Artie shakes his head. “Too detailed—and defensive. C’mon, you’re a great man now. What’s our mantra?”
“Prove it” is, again, the group response.
Viktor, who resembles a youthful Omar Sharif, smiles triumphantly as he play-acts confident sincerity to the mock personnel interviewer, “There is a gap,” he agrees, “although it doesn’t define who I am today.”
The group falls silent, then breaks into hoots and high-fives. “Damn, I wish I’d said that,” says Gerry, putting his head back in his hands.
Job interview dress rehearsals are a sign the group is in the final week of the three-and-a-half month MAP course. MAP, now in its 15th year, is preparing to graduate its 100th class. It has more than 1,100 alumni and the backing of the US Department of Housing and Urban Development and the National Conference of Mayors. Its radical approach is to accept that crime, addiction, and other acts of madness are irreparable results of tough lives. Recovery doesn’t come from exploring the ugly details of the past, but replacing them with the honor and determination of being a productive citizen. With a 68 percent success rate, the concept has been duplicated in 10 other states.
Along with interviews and resume writing, Gerry’s class practiced other workplace protocol, such as presenting ideas, carrying out instructions on deadline, and selecting the right clothes for critical meetings with potential employers or landlords. A couple of weeks earlier, Artie walked the group through Myers-Briggs exercises to define their strengths and interests, and decide what sort of degree or certification to pursue, and how. Participants began the course by collectively assembling individual “life maps,” detailed descriptions of how, when, where, and why each class member’s behavioral arc was dictated by the unholy trinity of hard times: addiction, homelessness, and prison. The acronym for the program is an apt one. Chart a course, change a life.
Fred Smith is the chief cartographer behind MAP. He quit a career as a Beacon Hill legislative aide to promote the idea that recovering addicts, former inmates, and the homeless can turn their lives around with a job and a place to live. MAP helps them find both with five days a week of intense classroom work.
“For very legitimate reasons, people wind up being what society only views as a useless mess,” says Smith, now director of program development, research, and evaluation at St. Francis House. “That doesn’t mean we’re not responsible for our mayhem, but a beautiful part of human nature is the urge to keep trying to get it right. Society and systems may not respect that urge, but MAP does.”
Despite MAP’s nationally recognized track record, a solid chunk of Smith’s time is spent in pursuit of grants and donations to keep the program moving ahead. As an incentive for attending the 14-week class, each student earns $140 a week toward the standard cost of a room in a group sober home. They also receive a travel card to cover public transit and a $60 weekly stipend.
Over the last 15 years, the cost of stipends, instructors, and materials has been partially bankrolled by HUD, the US Department of Education, the Federal Probation Department, the Massachusetts Parole Board, and private donations. The total cost is about $11,000 per student, a quarter of the cost of a year in prison, or close to the full price for three days in the psychiatric unit of Massachusetts General Hospital, where individuals with advanced addictions often end up. MAP has a steady waiting list of more than 100 people, partly because judges, probation workers, and parole officers often mandate it as a condition of release, or as an alternative to going to prison in the first place.
Smith’s tiny office on the third floor of the 11-story St. Francis House has a steady traffic of people like Ken, a worried-looking man in his late sixties, wearing shorts on a cold afternoon. In trouble with his overseers at probation and parole, he nervously asks: “Can you help me, Fred? Can you?”
“I’ll do my best,” Smith says, watching Ken walk quickly out of his office. “He did 20 years on a second-degree murder charge for an incident he had very little to do with. As you can see, like so many people who get blamed for crimes they didn’t do, he’s mentally disabled.”
Ken was released on the condition he remain on both probation and parole for the rest of his life. “He recently went to an AA meeting with two people who have former records as well. Apparently that breaks one of his parole rules, so they pulled him from his job,” says Smith, shaking his head at what he calls the “punitive absurdity” of life both during and after prison. “It’s the balancing act in our society between rehabilitation and retribution that just won’t quit. I call it ‘the Uncle Clarence syndrome.’”
When Smith’s father was a boy during the Depression, he and his brother, Clarence, were separated. While his father went to a foster care family, Clarence was shipped to the Walter E. Fernald School in Waltham. At the time, Fernald was an orphanage and hospital for “feeble-minded boys.” (It later underwent massive reform following a class action lawsuit in the 1970s spurred by allegations of physical and sexual abuse.) One day, Clarence got into a scuffle that ended when he swatted another boy with a broom handle. He was promptly shipped off to Bridgewater, then referred to as “the prison for the criminally insane.” A look of incredulous disgust crosses Smith’s face. “Forty years later he was released with a bus ticket to Boston and the name of a minister.”
Clarence’s release led to the epiphany that resulted in MAP. “I stepped in to help Uncle Clarence. All he needed was a little support, respect, and a place to live. Just when he was finally starting to pull his life together, he died. He was my first exposure to the gritty, heartless result of people who don’t know how to live after years of being homeless and institutionalized.”
About a year shy of becoming a vested state employee, Smith quit his Beacon Hill job. “I didn’t want to be part of the bureaucracy that simultaneously creates, and is utterly oblivious to, the Uncle Clarences of the world,” he says. “I had a simple idea. What people like him really need are the basics: a place to live and a job. What they don’t need are more pharmaceuticals, more testing, forced self-introspection, and restraints. Honestly? I didn’t know what the hell I was doing, but I think it works.”
The idea that the most effective way to modify habitual misbehavior is to replace it with new habits that feel just as good as the bad ones do at first has won the support of Dr. Howard Shaffer, the director of the Division of Addictions at the Cambridge Health Alliance. Shaffer was recruited to St. Francis House to be the psychiatric advisor when Smith was hired.
At the time, programs that incorporated simple, paying jobs as part of therapy for the mentally disabled had been successfully tested. But Smith was focused on what the psychiatric community refers to as the “mentally distressed.” Says Smith: “My goal wasn’t grocery bagging. It was to have people achieve long-term, mainstream employment, emphasis on mainstream.”
Shaffer says Smith was on to something. “Work, in the form of a job, is the cornerstone to recovery,” he says. This is contrary to the conventional wisdom that repairing mental health fosters material stability. “Fred and I have flipped it. There’s no motivation to get your mental health in order unless you’ve got something to get it in order for. Get a job and a good place to live, and good mental health will follow. No one, especially not someone who has spent their life in extreme fight or flight mode, wants to sit around and think about what made their life a mess.”
While academic think tanks and social service academics offer a mixed bag of recovery techniques, with arcane titles such as “behavioral methodology” or “multi-phase inventory,” MAP’s curriculum never wavers. “It’s the people who do it, ya smarty-pants.” is Smith’s cheerful, laser-beam mantra.
Smith describes a woman who joined his program as a condition of release after being incarcerated for attempted murder. “Like so many women, she had fought back after years of surviving domestic violence,” he says. Finally, on the condition she complete MAP, she gave Smith an idea —expand the program to focus on the simple but socially critical empowerment of looking good. “What an important and simple thing for us to ignore,” he says with a quick whack to his own forehead. Within 10 days she presented him with a formal proposal and “Studio Shine” was born. Now job and housing seekers have an entire room filled with clothes, makeup, and guidance on how to find the right “look” for the mission at hand. “It seems superficial, but it’s a huge breakthrough for so many people who have never been told, ‘Hey, you’re looking good.” Smith says. “Besides, we might be just about the only place on the planet that offers an image consultant to the homeless and ex-cons.”
What Smith refers to as Dr. Shaffer’s “radical Columbo approach” has reinforced Smith’s original theory that respect and support lead to surprisingly cost-effective results. “Like Columbo, he can see why the person did the crime, or in this case, created a crisis, in a way that’s so simple some professionals in his line of work consider it ass-backwards,” says Smith.
To confirm that a humane approach trumps punitive action, or meds, Shaffer has pushed Harvard to start measuring the technique’s success, or failure, employing a computer program called LEAD (Linking Evaluation Assessment Data). It involves detailed, and consistent, interviews with MAP participants from the first day they arrive to months and years after graduation. Although MAP’s goal is for enrollees to have a place to live and work, or at least secure prospects by graduation, staff and resources remain available indefinitely to all graduates, employed or not.
Anyone who walks down Boylston Street off of Tremont near the Ritz Carlton Boston Common has seen the daily sidewalk crush that occurs for the 85,000 free meals a month that St. Francis House offers. But the life-saving cuisine is just the tip of the subsistence iceberg. The humanitarian life-support system was created nearly 30 years ago, when Franciscan monks from nearby St. Anthony’s opened a shelter and soup kitchen for Boston’s burgeoning homeless population. The St. Anthony’s rector, Father Louis Canino, and Ira Greiff, a relocated clinical psychiatrist from New York University’s School of Medicine, merged their spiritual and medical perspectives—and influence —to stage a vast expansion of the shelter in 1984 with the purchase of the former Boston Edison building as a place to offer more than the basics of food, shelter, and clothes.
“What a lot of people don’t notice as they quickly skirt a crowd generally described as the down and out,” says Shaffer, “is what’s actually happening inside the 11-story building to repair the chronic battle fatigue that comes from living in society’s margins.”
MAP classes meet on the middle floors. Above them are four floors of single dorm-style rooms and collective kitchens for the “Next Step” program. Stable, low-cost housing is offered as a follow-up to some of the “guests” who complete MAP and acquire a job. Two other St. Francis House floors are dedicated to medical and therapeutic help. There’s a floor devoted to showers and clothes, and a safe and peaceful all-day women’s drop-in center.
Most people who cross the street to avoid proximity to street people would be surprised to see the program’s fully-equipped art studio. It’s a creative oasis where homeless guests spend hours painting, sculpting, and weaving. Their work regularly hangs in lobby of City Hall, South Station, and several Boston galleries, where pieces regularly sell to a small contingent of buyers who know surviving hard times can be a catalyst for some of the greatest art.
Into the elevator past Smith’s office squeeze Viktor, Gerry, Angela, and the rest of Artie’s class carrying rolled-up floor mats. “We’re off to solar gaze,” Angela announces. “One of the best times of day.”
“Yeah,” agrees Viktor. “When our brains stop their endless manipulations and maneuvers.”
The latest addition to the MAP curriculum, called the Wellness Initiative, came from a volunteer who regularly teaches yoga and meditation for well-heeled but job-stressed employees of Fortune 500 corporations. She translated it down to street level. Witnessing frequent staff frustration over the inability to teach MAP participants to think before they act, she suggested that Smith include feeling good with looking good. Wellness Initiative instructor Ivor Edmonds says the idea is to do something that has a quick reward system like drugs and alcohol once did.
“If I ask you to exhale and reach for your toes, it doesn’t require some long cognitive process. Success comes quickly, and feels good,” Edmonds says. “What many of these people have gone through is so deep in their cell structure, talk therapy won’t cut it.”
Today’s outdoor meditation class on Boston Common begins with solar gazing, a meditation in which Edmonds asks the class to close their eyes and imagine the sun’s warm light pouring into the center of their foreheads. “Let it melt the knots inside your head.”
“See ya, seasonal affective disorder,” whispers Andrea.
“Shhhhhhh. No more talking or thinking,” Ivor reminds the class.
A week later, the same group is now spotlessly dressed in ties, suits, and dresses at the Union Club on Park Street. When asked why MAP’s 100th graduation would take place with a sit-down lunch on the fifth floor of the posh, members-only club, Smith is quick to point out that it’s exactly where MAP graduates, coaches, and innovators belong. “This place was formed in a dark period during the Civil War. It was a place where people with what was called ‘like-minds’ could talk and be supportive,” he says. “That’s MAP in a nutshell.” To highlight that egalitarian ideal, the facility and the sumptuous buffet are being donated by supporters.
Amid clinking glasses full of iced tea and a low, expectant murmur, the graduation is thick with the congratulatory fanfare one hardly associates with hard times. One announcement brings a flurry of applause. Based on nearly $15 million raised, MAP classes will soon double to graduate 200 people a year.
Everyone in the room is a true believer in Fred Smith’s simple idea, but none more so than the graduates of the 100th class, all dressed and coiffed by Studio Shine style consultants. When Gerry proudly strolls up to collect his diploma, he’s obviously working to contain an emotional rush of tears.
“MAP is like a witness protection program. It protects me from the worst I’ve seen in myself,” he says. He pauses for the laughter to subside. “If I forget a lot about these 14 weeks, I will always remember two things I heard over and over again: The first is: ‘It’s up to you.’ The second is, ‘Prove it.’”