6 months in: ‘The Launch of PIE’; Time to Reflect….

18.10.19: This week I am delighted to announce that Centrepoint have officially launched their Psychologically Informed Environment (PIE) across the organisation (c.f. https://centrepoint.org.uk/about-us/blog/pie-an-introduction-to-psychologically-informed-environments/). Our approach to PIE has been informed by the past research evidence on PIE, as well as conversations with other psychologists working in the homeless sector, and an almost 6-month scoping exercise wherein I, as PIE Lead for Centrepoint, visited all our services and teams across the UK, meeting with staff as well as young people (e.g. the ‘PIEineers’; see previous blogs) in order to ‘co-produce’ Centrepoint’s PIE to be specifically relevant for our organisation. This week’s launch of Centrepoint’s PIE is far from the end of this process, but it is perhaps an appropriate time to pause and reflect.

One of the main things I have realised on my journey to this point, is that rather like a real PIE, which comes in many flavours or recipes, a psychologically informed environment (PIE) needs to apply psychological approaches and reflective evidence based practice to the specific context. Of course, any PIE needs to have some basic ingredients that make it a PIE. You need to combine flour, butter and water to make your pastry, but what fillings you decide to use depends on the context. Is this a savoury PIE for a family dinner, or is this a sweet PIE for a pudding? Similarly, a psychologically informed environment (PIE) has some essential ‘ingredients’ or components (c.f. https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf), such as a psychological framework that aids understanding of the thoughts, feelings and behaviours of others, the provision of staff training and support, the use of reflective practice, a consideration of the physical environment and the importance of evaluation. However, how these are operationalised must depend on the context in order to be successful. In the same way that no two individual homeless young people are the same, each organisation is also unique. Centrepoint has been helping homeless young people for 50 years now, and our approach has had to change as times have changed. Our core mission to give homeless young people ‘a home and job’ has remained consistent but the challenges that homeless young people face has changed over the past five decades due to changes in society, culture, social policy, statutory systems and legislation (e.g. https://centrepoint.org.uk/media/3375/talkin-bout-my-generation.pdf), and hence our strategy or approach has had to remain adaptive and flexible.

Consequently, although Centrepoint have launched our ‘PIE’ this week, and will be implementing various key PIE elements noted above, this is not the ‘end’ of perfecting ‘our recipe’. We will be evaluating and reviewing PIE as we move forward to ensure that as an organisation our PIE approach remains reflective and adaptable to meet any new challenges in the future. This means in practice that we will be working with our academic partners to measure both objective and subjective outcomes for both staff and young people, to ensure that organisational changes resulting from a PIE approach result in positive outcomes for those that work in or use our services.

There is little published research upon PIE’s to date, further arguing for the importance of Centrepoint reflecting upon and evaluating their approach as it develops, but where there is research (e.g. Stronge & Williamson, 2014; Cockersell, 2011; Phipps et al, 2017), PIE has shown to have beneficial outcomes for both staff and service users. For example, improving engagement or attendance rates, motivation to change, EET (Education, Employment & Training) outcomes, and improvements across the Homeless Outcome Star for service users, as well as increasing staff skills, knowledge and satisfaction, and reducing burnout and attrition. We plan to have some initial data to present with other colleagues working in this sector within a PIE symposium at the British Psychological Society’s Division of Clinical Psychology Conference in early 2020 (https://www.bps.org.uk/events/division-clinical-psychology-annual-conference-2020), which presents a great opportunity to gather together with others working in the same field to reflect on good practice and exchange ideas.

As part of my training as both a Clinical and a Forensic Psychologist, I have been encouraged to stop and think, rather than just constantly ‘do’. The ability to reflect upon what you are doing and why, and what impact you are having on a process, as well as what impact that process is having on you, is a key psychological skill. Such ‘meta-cognition’ or ‘thinking about thinking’ is argued within a PIE to be critical, and PIE organisations need to offer their staff space to do this through ‘reflective practice’. Often in life, we are constantly ‘running to keep still’, and carry out actions and behaviours because ‘that is what we have always done’. However, a PIE argues that space to reflect upon our practice, to consider the unique features and context, is important. Moving forward Centrepoint will therefore not only be evaluating and reflecting on our PIE journey through ‘research’, but we will also be offering all staff monthly reflective practice sessions, facilitated by a Clinical Psychologist, in order to embed reflective thinking across the organisation and improve outcomes for our staff and the homeless young people that use our services. ‘Holding a mirror’ up to what we do and why we do it, learning from the past 50 years but always with an eye to what we can do even better in the future, will help us to grow and improve as an organisation ultimately allowing us, as well as the staff and young people within Centrepoint, to reach our potential.

Overall, the past six months have been a real learning process for me, both professionally; as a psychologist moving from the NHS to a charity role, and personally; meeting and learning from so many amazing people whilst developing Centrepoint’s PIE. I am honoured to be leading PIE in the organisation, and am excited about our next steps following the launch this week. Finally, but most importantly, I would like to take this opportunity to thank all those individuals within and outside of Centrepoint, that have given up their time so far to help me develop our PIE ‘recipe’. You have inspired me, challenged me, listened to me and supported me, and this week’s Centrepoint PIE launch belongs to all of you… #WeArePIE

Consultant Clinical & Forensic Psychologist & Centrepoint Psychologically Informed Environment (PIE) Lead @orange_madbird