Post on 14-Dec-2015
PSYCHOLOGICALLY INFORMED ENVIRONMENTSJean Templeton
St Basils
THE VISION…• To see adequate provision made in
homelessness services facilitating effective treatment for psychological issues within homelessness
• To ensure that staff are adequately equipped to effectively deal with complex problems
• 2008 Rough Sleepers Strategy
WHAT IS COMPLEX TRAUMA? A number of terms used interchangeably
Complex Trauma
Complex PTSD
Type II Trauma
Disorders of Extreme Stress Not Otherwise Specified (DESNOS; DSM-IV (APA, 1999))
Describes observations of:
Alterations in emotion and impulse regulation
Dissociation
Changes in self-perception
Difficulties relating to others
Somatisation
Alterations in belief systems held by the individual
ISSUES Interpersonal issues
Attachment Emotion regulation Negative beliefs about self and others Impulsivity Other trauma experiences
Flashbacks, rumination Complicated by natural processes in adolescence
Identity formation (beliefs, belonging) Emotion regulation ‘Separation’
PSYCHOLOGICAL, EMOTIONAL AND BEHAVIOURAL PATHWAY TO REPEAT HOMELESSNESS
Childhood abuse / neglect
Emotion dysregulation
Experiential avoidance
Maladaptivecoping style(externalising)
Rumination
Shame, guilt
Drug and alcohol use
Asocial and antisocial behaviour
Lack of social and practical functioning skills
Repeat tenancybreakdown
Triggers:
•Release from prison•Relationship breakdown•Discharge from armed services•Loss of tenancy
Modelling
Attachment problems
PSYCHOLOGICALLY INFORMED ENVIRONMENTS (PIES)
Whole environment operates according to an agreed psychological framework Keywork sessions Use of reflective practice Residents’ meetings Peer mentors
Environment may also reflect psychological thinking Residents’ input into surroundings Residents’ use of facilities
Effects are monitored (measured) Meaningful
CHANGE Need to be clear about what it is we expect to
change For clients For staff For service
Clarity about how we expect to facilitate change Emotional change Behavioural change Cognitive change Change in attachment experience
PIPIE AIMS AT ST BASILSE AIMS AT ST BASILS
• Improve positive outcomes for young people, build resilience and capability and enable them to move on and sustain their independence in an increasingly challenging environment
•Ensure staff have skills, attitudes, behaviours and resilience to cope and support positive outcomes for young people
ELEMENTS OF THE PROGRAMME
1. Core training in psychological skills for all staff
2. Specialist training for some
3. Development of evaluation framework and infrastructure and review and analyse data over 3 year period
4. Reflective Practice groups in collaboration with NHS partners
5. Review tools and working methods to ensure they support an approach consistent with Psychologically informed environment
Professional Standards Personal
Effectiveness Organisational Effectiveness
- Reflective
Practice
Outcome-Led Approaches
-Payment by Results
Young People’s Voice
Co-Production-
Personalisation
OUR PARTNERS
Dr Nick Maguire, Senior Clinical Psychologist, Southampton University
Birmingham and Solihull Mental Health Foundation Trust
Department of Communities and Local GovernmentPro Bono EconomicsLondon Housing Foundation University of Birmingham – Mental Health Study positive outcomes for young people
LEARNING AND IMPACTS
Reflective practice in consistent groups is absolutely critical Embed techniques and approach in all your work Part of induction and regular refresh
Year 1 KPIs: 13% reduction in serious incidents 50% reduction in NTQs for behavioural issues 19% reduction in unplanned departures 26% reduction in sickness absence 7% reduction in grievance and disciplinary actions
PIE at St Basils
Youth Involvement Review
Equality and Diversity
Action Plan
Training and L& D Programme
ReflectivePractice
Mental Health First Aid
Programme
3 year monitoring and review
Lifeskills programme
Asset ManagementStrategy
Outcomes Star
IntegratedApproach to LSW
REFERENCES
DCLG – Psychologically Informed Services for Homeless People- Good Practice Guide February 2012 www.stbasils.org.uk/publications#external
jean.templeton@stbasils.org.uk