‘Partnerships, Relationships & Communication in a PIE’

08.11.19: This week I have reflecting again about the importance of relationships and partnerships within a Psychologically Informed Environment (PIE), after having spent some time this week liaising with staff as well as external partners to Centrepoint, building relationships with those who have a shared interest in delivering the best possible outcomes for homeless young people in the UK. As the PIE Good Practice Guide (c.f. Keats et al, 2012: https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf) notes; ‘A focus on managing relationships is perhaps at the heart of what makes a psychologically informed environment different’ (p.24). Whilst this refers to the important of the therapeutic relationship between staff and young people as a principal tool for change, and in previous blogs I have discussed the importance of building relationships with young people, I have been thinking that being PIE means that we also need to consider the working relationships between staff, as well as with our external stakeholders and partner agencies.

Therefore, this week I have met with HR colleagues within Centrepoint to ensure that our ‘People Strategy’ is psychologically informed, considering the importance of collaboration across the organisation to ensure that our staff are supported, developed and empowered through a psychologically informed culture. I have also spent time having very productive conversations with other organisations (i.e. Homeless Link) about the development of trauma or psychologically informed trauma training specifically for homeless young people, as well as discussing Centrepoint’s PIE plans with our statutory agency partners in Camden, North London. Themes from these discussions have been the importance of ongoing partnership working, sharing of evidence based practice and learning within the sector, psychologically informed staff training and the importance of information sharing (e.g. risk information). Although the perception of a psychologist is often someone sitting in a room with one other offering some kind of individual therapy (i.e. a ‘micro’ level approach), psychologists can also have a crucial, albeit more challenging perhaps, role in building relationships more systemically, and encouraging the embedding of psychological thinking at a ‘macro’ level.

In order to make relationships or partnerships work, good communication is key. This is again highlighted in the PIE Good Practice Guide, which also notes that sometimes this can be difficult. However, ‘the ‘difficult conversations’ should not be avoided, but discussed openly … in all honest relationships, there will sometimes be disagreements: these should be aired, and a negotiated position achieved’ (p25). Of note, Keats et al (2012) go on to point out that; ‘the more staff and management do this, the more natural it will be for this to happen in staff/client interactions, and indeed in client/client interactions’. Therefore, although communication can sometimes be a challenge, particularly when individuals in the conversation are coming from different perspectives, different positions of power, different languages, and/or have had different past experiences; as humans are innately social animals, much of our day is spent communicating with each other and it is important to reflect further on how we do this.

The Oxford English Dictionary (1989), defines communication as “the imparting, conveying, or exchange of ideas, knowledge, information, etc. (whether by speech, writing, or signs)”. Thinking psychologically however, the interpersonal aspect of communication is critical. For example, Stewart & Angelo (1998) in their book ‘Together: Communicating Interpersonally’ define communication as an ‘interpersonal process’, which ‘is a mutual, relational, co-constructed process, as opposed to something that one person does “to” someone else’ (p.131). We therefore bring ourselves into the interaction with another, and our interpersonal communication is often based upon our ‘interpersonal needs’. As long ago as 1958, Schutz argued that three categories of interpersonal needs are critical in communication; that of inclusion, control and affection. In other words, we communicate with others to develop our relationships and sense of belongingness, to achieve influence or power, and to develop friendship, closeness and love with one another. Each individual’s interpersonal needs are different however, and may be different at different times and in different contexts. A PIE approach to communicating with others, would therefore suggest that we should be mindful of another’s needs when communicating with them because successful interpersonal interactions are when both parties’ needs are met. Consequently, when we communicate with homeless young people, other staff or external stakeholders, holding in mind what the other person ‘needs’ to gain from this interaction can help it be successful, positive and relationship building.

So how can we do this? When training to be a Clinical Psychologist, I remember several supervisors commenting to me that there is a reason that humans were born with ‘two eyes, two ears and one mouth’. It assists the building of relationships with others when you observe and listen more than you speak. Paying careful attention to what someone else is ‘doing’ and ‘saying’ when listening, rather than just thinking about what you should say next, is important. Sometimes we can be better at this than at other times. I personally find when I am anxious or time pressured in an interaction, this can be more challenging. Moreover, only speaking English, but having had the pleasure of working with individuals from a diverse range of backgrounds over my career, has meant that at times I have had to really focus on what someone is trying to communicate to me, especially if English is not their first language.

For example, I have witnessed the frustration of past clients trying to express themselves in a foreign language when trying to articulate their inner worlds and needs, even when utilising interpreters. And indeed, much challenging behaviour that an individual may present with (c.f. last week’s blog), can be understood as resulting from difficulties in communicating with another person. I am reminded of my own children, when they were much younger, struggling to ‘use their limited words’ to tell me what they wanted to how they were feeling, which often led to verbal and physical aggressive outbursts borne out of sheer frustration! Indeed, one of the conversations I had this week with Centrepoint’s statutory partners, was about the psychologically informed delivery of services to homeless young people in North London who are ‘unaccompanied minors’ or refugees from counties where their first language is Arabic, not English. I reflected on how confusing and difficult it must be to navigate the complex benefit, housing, education and employment systems in the UK, when even the print (as well as the sound/pronunciation) of the English language is so different. Consequently, access to translation services, the provision of translated written information, and as noted by a housing and support staff member in the Equality and Diversity training that I attended when I started at Centrepoint, even the availability of an English-Arabic dictionary for staff to use will be key in building relationships across language barriers for this specific group of homeless young people.

Finally, I am very excited to announce that Centrepoint are supporting the delivery of their PIE moving forward by investing in additional Clinical Psychologists to work alongside myself and develop relationships within the different regions that the organisation is currently operating in. Therefore, if you are a psychologist either in London or the North, with an interest in PIE approaches and making a different in the lives of homeless young people, please do take a look at these vacancies via https://jobs.centrepoint.org.uk/. I am looking for individuals that can communicate well, and build relationships with staff, homeless young people and external stakeholders in order to make Centrepoint’s PIE help #changethestory…