More for less? Using PIEs and recovery to improve efficiency in supported housing

Abstract

PurposeThe purpose of this paper is to describe an example of a practical evidence‐based approach to improvement in the current climate of funding cuts.Design/methodology/approachThe paper describes synthesizing insights from leadership, change management and psychodynamic theory to inform a practical change programme to develop services that meet the needs of clients more efficiently.FindingsThe paper finds that rather than simply doing less – cutting staff or reducing services to meet the constraints of funding cuts – it is worth taking a long term and strategic review approach and doing something quite differently.Practical implicationsNew ways of working can improve client outcomes and deliver better services and the funding cuts can provide an opportunity to thoroughly re‐examine existing provision; but, significant changes will only be accomplished by change processes that pervade the whole organisation – they cannot just be add‐ons/afterthoughts. The implications of the new way of working are that: even when funding increases, old ways of practice will not be restored; that the use of theoretical approaches from a variety of disciplines can deliver innovative responses that are likely to be sustainable in the medium term; and to improve service standards and outcomes into the future.Originality/valueThis paper finds value by looking to neurobiology, clinical psychotherapy, recovery‐oriented practice, change management theory and practice, and client involvement to try to resolve the current housing crisis.

An exploratory study on the factors affecting the mental health and well‐being of frontline workers in homeless services

“…To create a statistically usable measure, we collapsed different types of supervision and support into one matrix, prioritising the model with the best evidence base for supervision of helping professions working with psychological trauma: individual and small group supervision with an appropriately qualified supervisor (Azar, ; Bell et al, ; Knight, ; Sommer, ). In doing so, we de‐prioritised the lesser evidenced RPGs, COP or CRGs (Anderson et al, ; Cockersell, ). Consequently, the matrix used for this study may not fully reflect the therapeutic value of some of the newer forms of support.…”

“…A range of different group discussion settings allow for this. Reflective practice groups (RPG) provide space for staff to process their experiences with colleagues and discuss alternative ways forward to better support service users (Cockersell, ). Case review groups (CRG) may focus on specific interactions with a client, often with support from an external clinically trained consultant to develop psychological formulations for observed behaviour and relational styles (Burley, 2016).…”

Understanding Models of Support for People Facing Multiple Disadvantage: A Literature Review

“…Several academic, government, private and third sector initiatives were launched to improve homelessness services between 2008 and 2015 as part of a growing awareness that people experiencing homelessness present with various psychological and emotional needs and the realisation that services were often ill equipped to respond. This deviates from a traditional behavioural approach which uses a regime of warnings with eviction as the 'ultimate deterrent' (Cockersell, 2011). Psychological perspectives offer a different way of working with people.…”

“…Moreover, training should ideally be provided to staff before they start working within a trauma-informed service. St. Mungo's has developed a range of training for staff at their PIE pilots (Cockersell, 2011). This includes client co-produced training on topics from attachment theory to motivational interviewing; management training so that managers can better support staff creativity; and the establishment of reflective practice groups.…”

Psychotherapy with people who smell

“…My role has been composed of providing psychotherapy to individuals (living temporarily in hostels or attending day centres whilst living on the streets), reflective practice groups for staff teams in homelessness services, and organisational consultancy. I will mention in passing that this combination of different types of psychodynamic intervention within an organisation forms part of a UK initiative to add a psychologically literate and nuanced dimension to traditional homelessness work, rendering hostels and shelters into so-called 'Psychologically Informed Environments' (PIEs) (see: DCLG, 2008DCLG, , 2012Haigh, 2010, 2011;Cockersell, 2011;Scanlon, 2012). The conceptual territory of this initiative involves exploring the intrapsychic and the psychosocial within settings consistently buffeted by shifting political directives and aspirations.…”