‘Vulnerability, connection and the value of relationships in a PIE’.
17.01.2020: As I reflect and write this week’s Psychologically Informed Environment (PIE) blog, the sun is finally shining after ‘Storm Brendan’s wind and heavy rain have stopped. This UK weather has made me reflect again upon how even more vulnerable homeless young people are during the winter season, due to their exposure to the elements (c.f. https://centrepoint.org.uk/about-us/blog/6-ways-to-help-homeless-young-people-in-cold-weather/). Combined with having also recently moved into our loft renovation (and being aware of how loud wind and rain sounds on the roof!), this has meant I have been thinking about the concept of ‘vulnerability’, and specifically how it can apply to all of us and how it can be overcome when we are ‘psychologically informed’.
I started this week by visiting our Manchester services (c.f. https://centrepoint.org.uk/manchester/) and meeting with leading staff delivering amazing support services to some of the most vulnerable homeless young people accessing any of our Centrepoint services. One of our teams in Manchester is unique as they are dealing with young people who are literally ‘walking in off the streets’ (i.e. ‘rough sleepers’) and who are often highly traumatised either prior to or as a consequence of homelessness, with associated physical and mental health consequences, including substance use. This not only makes the young people vulnerable, but also our staff, as they are truly ‘frontline’ in the battle to #endyouthhomelessness. This particular work brings about significant challenges, not only in terms of engagement and complexity issues related to homeless young people but also in terms of how staff manage risks as well as their own emotional well-being and any ‘vicarious trauma’ (i.e. the emotional residue of exposure to hearing trauma stories and being witness to pain, powerlessness, fear and distress). I have also spent some time with staff in other London services this week, offering a staff support session to one service following the unexpected passing of a valued colleague and meeting with another staff team managing a large complex service, to discuss how PIE approaches may be helpful for them.
Reflecting on all these meetings/sessions across varied services, I was once again struck by the significant challenges that our staff have to deal with in ‘frontline’ services and how emotionally difficult such work can be. The very person-centred qualities of active listening, empathy, and unconditional positive regard (e.g. Rogers, 1951) that we value so much in undertaking any social or health care role, can also make us ‘vulnerable’ to overwhelming distress, burnout and stress. Maslach (1982) has noted that this is an occupational hazard in any caring profession, as when we care, we give something of ourselves to that person we are caring for, and we need to ensure that we take time to replenish ourselves or risk overwhelming exhaustion, feelings of cynicism and detachment, and a sense of ineffectiveness and failure. However, it is important to note that feeling such emotions is ‘normal’ (indeed if we were not impacted by the distress of others, this would be more concerning!), and so ensuring we actively manage this risk through personal and collective self-care is critical.
Importantly, what I also noticed this week, aside from the staff’s shared emotional experiences, was how they helped to manage these by working collaboratively and compassionately with each other as a team, supporting and ‘holding’ each other in mind when things were difficult. A key aspect of any PIE has been argued to be ‘relationships’ as ‘a focus on managing relationships is perhaps at the heart of what makes a psychologically informed environment different’ (c.f. https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf; Keats et al, 2012; p.24). This is commonly related to the relationship between the homeless individual and the staff member being a power catalyst for change (i.e. a ‘therapeutic relationship’), but I would also argue that it relates to relationships between staff within individual teams. Prior to my role in Centrepoint, I worked for many years with highly complex clients in various statutory forensic mental health and criminal justice services, and what was invaluable undertaking this work long term was the ‘team’ around me. Specifically, the importance of the formal and informal support that my team offered to each other on a daily basis; a ‘connection’ to others in the same situation that was based on honesty and an understanding of each other’s ‘vulnerabilities’, as well as a willingness to share and support each other to overcome these. This team ‘connectedness’ built our individual resilience to cope with the daily emotional demands of our roles.
Psychologists have long argued that human beings are innately social creatures, that are biologically programmed to build relationships ‘or attachments’ to those that can offer us care and support (c.f. Bowlby, 1967: Attachment Theory). Such early childhood attachments shape our view of ourselves, other people and the wider world, and enable us to develop emotional regulation, resilience and self-confidence. However, this need for ‘connection’ with others for our psychological well-being does not end when we become adults. We all need a friend, a partner or a family member to understand us and support us when things are difficult throughout our lives and it can be arguably no different or less important within the workplace to ‘connect’ with and support others. This is particularly important when our work can be very emotionally challenging due to the complexity of homeless young people’s needs or we become frustrated by the wider systems or social policy landscape we operate within.
As we continue our PIE journey in Centrepoint, we will therefore not only be considering ‘the emotional and psychological needs’ of the homeless young people referred to our services (c.f. Johnson & Haigh, 2010), but also those of our staff, without whom nothing we do so successfully as an organisation would be possible. Key to this, as discussed in previous blogs, is to create ‘team spaces’ for sessions such as Reflective Practice (c.f. https://www.homeless.org.uk/sites/default/files/site-attachments/Reflective%20practice%20briefing%20March2017.pdf), which amongst other learning outcomes can also enable staff to further build connections and emotionally support each other. Consequently, having listened to staff needs and preferences this week in Manchester, it was agreed that staff in this region be prioritised for monthly reflective practice within the organisation. They not only face the specific local challenges highlighted above, but are also currently experiencing their own ‘homelessness’, as they operate out of temporary accommodation whilst our Oldham Street Manchester hub is being renovated and refurbished in accordance with PIE physical environment principles. Therefore, I very much hope that these regular reflective practice sessions will be particularly helpful to our valued Manchester staff during this ‘vulnerable’ transition period, and I very much look forward to working with them (as well as all of our Centrepoint staff, including my current London teams) over the coming months…
