‘Room 101: What would you banish for good? Making psychologically informed changes: from the strategic to the individual’…
19.03.2021: As I was starting to write this week’s blog as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity: Centrepoint, I realised that this week marks the 101th week that I have been in this role in the organisation. This immediately made me think of ‘Room 101’, a UK comedy television and radio series in which celebrities discussed their ‘pet hates’ and attempted to persuade the host to consign these to oblivion in a fictional ‘Room 101’. The concept of ‘Room 101’ is of course is based on the room that held “the worst thing in the world” in George Orwell’s (1949) famous novel ‘Nineteen Eighty-Four: 1984’, which outlined a dystopian future reality. This got me thinking about what I might want to banish into such an imaginary place as ‘Room 101’ this week and I realised that there was actually quite a lot! For example, these included significant current issues such as systemic racism and discrimination, health inequalities, COVID-19, sexual violence against women and gender inequalities, and of course homelessness in any form, particularly youth homelessness. I also would not miss some perhaps smaller things such as cars that cut me up when driving around London, mushrooms on pizza, clothes that shrink when washed, and people that do not pick up after their dogs in my local park!
However, whilst the social anthropologist Margaret Mead commented in 1978: “never doubt that a small group of thoughtful, committed citizens can change the world. Indeed it is the only things that ever has”, sometimes with these bigger social challenges we can feel that we cannot make a change and these issues may never be addressed or banished forever into an imaginary ‘Room 101’. Consequently, I have been thinking this week about what in the context of our organisation we can change, particularly by taking a psychologically informed or PIE approach, which is also particularly timely with the launch of Centrepoint’s new 5-year strategy. This strategy has the ambitious goal of ‘ending youth homelessness by 2037’ and I am pleased that PIE is embedded throughout all aspects of it. Why 2037 you might ask? Well, this is because if a young person is born today in 2021, we would like them not to need to access a Centrepoint service by the time they reach their 16th birthday or the point in which they become eligible to do so. In other words, we want to put youth homelessness into ‘Room 101’; thereby banishing for some of the most vulnerable young people in the UK, the ‘worst thing in the world’. So how do I think that PIE underpins the different aspects of this Centrepoint strategy and #endyouthhomelessness (without an actual ‘Room 101’!)?
The first part of the strategy is to ‘Optimise’ what we are already doing well and create a resilient organisation that is inclusive, efficient, productive and adaptive. This will involve significant investment in the staff that work within the organisation, the properties that we utilise for both our frontline services and support teams, our digital capabilities and our financial capacity to respond as needed over the next 16 years to whatever challenges the post pandemic world throws at the organisation. From a PIE perspective, the focus on improving our physical environments is critical in order to ‘make a house a home’, as highlighted in Keats et al (2012) PIE Good Practice Guide (https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf). Specifically, this notes ‘the importance of the environment on the individual’ and ‘on such outcomes as perceived well-being, negative emotions etc.’ (p.19).
Investment in the staff that work for Centrepoint is also key within a PIE, specifically through ensuring high quality and regular staff training, support and reflective practice. Again as Keats et al (2012) note ‘staff training and support is … central to the transition into psychologically aware services’ whilst reflective practice is ‘the process of continuous learning from professional experiences, which encourages problems solving and critical thinking skills’ (p.21). This is important as ‘key working clients with complex trauma [i.e. homeless or vulnerable young people] can be challenging and exhausting, but adopting a reflective approach, especially after difficult incidents, can enable staff to learn from experiences and thereby improve the way they respond when something similar happens again’ (p.21). Therefore, both these approaches help us to develop ourselves through reflection and continuing professional development that help us to think about what we are doing and why we are doing it. This ensures that we banish any unhelpful ways of working to ‘Room 101’ and learn new psychologically informed ways to work in order to improve ourselves as well as the outcomes for those homeless young people we work with.
The second part of the strategy is ‘Prevent’, which focuses on reducing the number of young people that are effected by homelessness. This will occur through various means such as increasing our national helpline response (Telephone Number: 0808 800 0661), partnerships with other organisations that provide direct prevention advice and support, and increasing our campaigning for youth homelessness prevention activities across the welfare, housing, education and care sectors. PIE can help to underpin this strategic element too, through the emphasis on ‘evidence based practice’. Again as Keats et al (2012) note ‘evaluation of outcome is crucial … if you don’t know what impact what you do or say is having, how can you know whether it is positive and how can you improve it? There is not a great mystique about evaluation: it is the opportunity to know which things you do or say and effective, in what situations and with whom’ (p.26).
The next part of the strategy, and perhaps the work that Centrepoint is most well-known for as it is where we started over 50 years ago as a charity, is ‘Support’. We want to keep delivering positive outcomes (e.g. ‘a Home and a Job’) to #changethestory for vulnerable homeless young people in our delivery sites (currently London, Manchester, Bradford, Barnsley and Sunderland). This means that all our services (i.e. supported housing services and independent living schemes, education, training and employment opportunities, our health offer and legal support) will be PIE informed and are based on the latest evidence based practice driving forward innovative ideas in the homeless sector.
Finally, again as per a PIE which argues for the evaluation and dissemination of good practice in the homeless sector, our strategy also focuses on the need to ‘Amplify’. This means scaling up our successful solutions, improving public awareness of issues related to youth homelessness and to encourage, partner with and support other organisations to work with us to banish youth homelessness to ‘Room 101’ for the next generation. Thus, as noted above under ‘Prevent’ we need to evaluate ‘what works’ and create a culture of ‘evidence based practice’ to ensure we change or stop what doesn’t work by consigning it to that ‘Room 101’, and use this evidence to be a national voice for youth homelessness, which includes the voice of homeless young people themselves.
Reflecting further on changes we are currently making within the organisation to be more psychologically informed, I have also this week continued to be involved with the HOMES project, which is soon to be launched within the Support and Housing Directorate (#watchthisspace!). This change programme is PIE based and aims to create a model of working that is psychologically safe and secure for our frontline staff and the homeless young people they support, thereby improving outcomes (Keats et al, 2012). This continues to be an interesting process whereby many key leads across the organisation have been challenging ourselves to reflect upon, collaborate together and revise many of our processes, policies and procedures, our training offer to our ‘frontline staff’, the physical environment and much more.
Consequently, many aspects of how we used to do things, which didn’t work as well as they should have done, have effectively been banished to an imaginary ‘Room 101’, whilst other have been revised, reviewed and hopefully improved. This is an ongoing collaborative process, which is intended to bring about positive change to ensure that our services are not only a PIE but also are optimised for this new post pandemic world. Of course, this is a journey, and I know from my conversations with many frontline staff in reflective practice sessions that in some places we still have some way to go. Nevertheless, I am heartened by conversations with other staff that much of our current operations are not even close to needing to being banished to ‘Room 101’! As I have commented before in this blog, Centrepoint is very much in the midst of an ‘evolution not a revolution!’
So how about psychologically informed change on an individual level, both professional and personally? This lockdown period has challenged us all to consider things differently, both at work and at home. As we head towards the ‘new normal’, what have we learnt that works that we could do more of? Perhaps this is about how we have started to consider our psychological well-being more, and have refocused our lifestyles to focus on what really matters to us and/or our values? Perhaps this is a new way of working either with our colleagues and/or those homeless young people we support, that has been more effective or flexible than we might have thought possible? In addition, what hasn’t worked, and so we might we need to banish it to ‘Room 101’? I would therefore encourage everyone reading this blog to stop and reflect on their daily lives or working practices for a moment as a mini PIE challenge this week.
Psychologists have for a long time looked at what underlies our behaviour and what causes behaviour change, from the earliest Behaviourist Psychologists (e.g. Pavlov, Skinner) almost 100 years ago, to more recent theories of motivation and behaviour change (e.g. The Transtheoretical Model; Prochaska & DiClemente, 1983). When thinking about ourselves and what we can do to improve, challenge or move forward, away from what we know are perhaps ‘bad habits’ and things we need to change, there are many psychological theories and plenty of advice. However, for the purpose of this blog I am going to focus briefly on habitual behaviours we might think about (or support those we are working with to consider) banishing to ‘Room 101’ in the future, and how to go about this.
Habitual behaviours are of course easy to make and much harder to break and we might need support from others (e.g. family, friends, colleagues) to do this. One quick way to remember how habitual behaviours are formed is to consider the 3R’s. This highlights first the role of ‘reminders’ (e.g. triggers or cues) that make us engage in a behaviour. I know for example, that I am much more tempted to have a cigarette after a meal as I have that stimulus (S) — response (R) association between ‘feeling full after a meal’ and wanting a ‘relaxing cigarette’ (and after many previous experiences of eating then smoking this is a strong learnt association). This S-R association then becomes a ‘routine’ behaviour (i.e. smoking), which is also ‘rewarding’ (i.e. the calming effect of having a cigarette), which helps make the habit stick. We do not tend to repeat S-R associations that are punishing or not rewarding as you would expect. Of course as Pavlov’s famous dogs, who salivated (R) every time a bell was rung after food (S) and a bell (S) were shown at the same time, will tell you (if they could speak rather than just bark!), then this S-R association is very strong, sometimes automatic and hard to break. Hence, the importance of stopping and reflecting ourselves on these ‘learnt behaviours’ and encouraging those we work with to do similar.
Fortunately, for those of us wanting to make positive changes, psychologists have also outlined some ways to break these negative or unhelpful habitual behaviours so that we can banish them to that ‘Room 101’. Firstly, we need to identify our triggers (the S noted above), thereby perhaps making something ‘unconscious’ (unknown) more ‘conscious’ (aware). This might be done by keeping a diary or record (e.g. on our phone) over a few days to see when the habitual behaviour (the R noted above) occurs (e.g. where, when, how we feel, who are we with, after what does it occur?). Then it is important to motivate ourselves to make a change — in other words, we need to focus on why we want to change. Perhaps we know our habitual behaviour is unhelpful or unhealthy or perhaps it does not fit with our values or goals. Listing all the reasons why we want to change can be very motivating especially when you place this list somewhere you will regularly see it as a reminder (e.g. in a work space or on the kitchen fridge!). Sharing our plans for change and enlisting support from friends, family and colleagues is also key, perhaps we even choose to work on something together?
In addition, it can be helpful to ‘start small’. As noted above at the start of this blog, many of the things I want to banish into ‘Room 101’ are beyond my individual control. However, by taking a small step (i.e. choosing as a psychologist to work for a national youth homeless charity) I am taking a step towards my wish to banish youth homelessness. Moreover, replacing the maladaptive or negative habitual behaviour with something else more adaptive so you can create a new S-R association is important. In my case, I have started to have a mint after a meal (the new R) when I feel full (the original S). Over time, this new S-R association will become stronger than the previous one, helping me to change the habit and hopefully quit smoking!
Importantly, we also have to be kind to ourselves (and those we support) when engaging in any change, as it is often difficult and can take time whether that is at a societal level or on an individual level. As the saying goes ‘Rome wasn’t built in a day’, so as an organisation our strategy to #endyouthhomelessness by 2037 is a necessarily long term one. Banishing things to ‘Room 101’ in reality is not as easy as it is in the television programme of the same name, which just involves the host pulling a make believe ‘lever’. Therefore, we might not get it right the first time. However, by reflecting on what we have learnt from our previous attempts (whilst accepting we might fail the first time but rewarding ourselves for any progress we do make), enables us to take an important step forward in order to keep motivated and take a step closer to ‘banishing’ it to ‘Room 101’ next time! Lastly, I believe it is important that we keep visualising and talking about the change that we want to see. It might be a challenge to get ‘those worst things in the world’ into Room 101, and it might take both a significant individual as well as collective effort, but at whatever level we are making changes, we have to keep going because it ultimately it will be worth it both for us and those that come after us…
