‘What do we need? — A psychologically informed approach to our well-being at work’…

Dr Helen Miles
12 min readJun 9, 2023

09.06.2022: As I write this week’s PIE blog, as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity — Centrepoint, it is lovely to take a moment to stop and reflect on the past week. It has been a very busy week as we are currently recruiting to the PIE team and so have several vacancies, meaning that we are busier than usual covering as much as we can within our limited resources. Consequently, I have noticed my stress levels rising and therefore my own self-care (as well as our team collective self-care) has been even more important than usual to avoid burnout and fatigue starting to set in. Whilst for me, self-care routines involve walking my dog and doing some daily yoga, it is important to remember that everyone’s self-care routine is different. Some people enjoy running or going to the gym for physical exercise, for others it is listening to music or taking a moment to read a good book on your commute home. In other words, self-care is not necessarily a ‘one size fits all’ approach involving the stereotyped ideas of self-care (e.g. scented candles!).

I have discussed the importance of self-care when working in the homeless sector in previous PIE blogs, see here: https://drhelenmiles.medium.com/coping-with-stress-a-psychologically-informed-reflection-on-keeping-that-balance-when-working-5b4b970a0f66 and here: https://drhelenmiles.medium.com/if-you-are-travelling-with-another-person-who-requires-assistance-secure-your-mask-first-before-a19f112c426 for examples. Arguably though, it is such an important topic for staff well-being, it is worth regularly returning to this subject to act as a reminder that self-care is not a luxury, it is in fact essential. How can we look after others if we are not looking after ourselves? However, in this PIE blog, I am thinking more about ‘psychologically informed’ self-care and actually want to ‘go back to the basics’, because even though we refer to self-care, sometimes the things that actually enable us to manage stress in the workplace, mean we need to consider what this means from an organisational perspective. In other words, how does our working environment ensure that we are looking after ourselves so that we can perform to our optimum in work, whatever role within the organisation we are working within?

Creating and embedding a PIE approach within the homeless sector, means we need to implement various things that help staff in the workplace to help the homeless people they support to the best of their abilities. For example, as Keats et al (2012) note (c.f. https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf) that staff need to have access to appropriate training, staff support and reflective practice sessions as well as working within a physical environment that is conductive to positive psychological well-being and safety. However, when I was reflecting on what else PIE might say about self-care, at a more organisational level, I came across the picture at the top of this blog. The picture may be familiar to some readers of this blog with a psychology background because it is based on Maslow’s (1954) renowned ‘Hierarchy of Needs’.

Maslow (1943, 1954) was a psychologist originally interested in what motivates humans, and developed a five-tier model of human needs, often depicted as hierarchical levels within a pyramid or triangle. At the bottom of the hierarchy are basic ‘physiological’ (survival) needs such as food, shelter, clothing, warmth, progressing up through the hierarchy to needs such as safety, belonging and ‘love’ and ending up with more creative and intellectually orientated ‘self-actualisation’ needs at the top. Importantly, it is argued that needs lower down in the hierarchy must be satisfied before individuals can attend to higher needs. Interestingly, Maslow’s argument is also that human motivation is not just concerned with tension reduction and survival but also with human growth and development, but that one is a necessary condition for the other.

To put this another way, we won’t be motivated to be creative, develop relationships with others or challenges ourselves (i.e. longer term ‘growth’ or psychological needs’) if we don’t have food or a secure place to live (short term ‘deficiency’ or biological needs). We have to attend to our basic priorities before we have the space or energy to attend to other higher priorities in life. We see this with the homeless young people we support in Centrepoint — we need to ensure that they have a safe and secure ‘home’ and access to enough food and other basic needs, before we can support them to access and succeed within more growth based needs such as opportunities for education, training and employment. If you are hungry and homeless, how can you study or gain employment?

Relating this back to self-care, hopefully the picture at the start of this blog is starting to make more sense — we need to ensure we meet our basic physiological needs at work before we are going to be able to address further higher up needs that contribute to our psychological well-being at work. From an organisational perspective, we do not want disengaged and demotivated staff, instead we need to aim to create an organisational PIE culture wherein staff are highly engaged and motivated and well-being is seen as ‘everyone’s responsibility — both individual staff as well as managers and wider systems.

Specifically, as can be seen in the picture, self-care or well-being needs at work, have to start with ensuring that we are attending to our ‘Survival’ or physiological needs first. Do we get the chance for lunch and/or tea breaks? Are we ensuring that we are keeping hydrated and our working environment is at an appropriate temperature — namely not too cold or too hot (the latter especially important now as the weather is starting to warm up for summer and we are expecting very high temperatures this weekend)? Do we have ready access to a toilet? Finally, are our working hours balanced? If we are working on the frontline, what does our shift pattern look like? Does it create opportunities for time off to rest especially if we have been doing lots of ‘long days’ or nights in a row, which can both take an increased toil on our biological systems? If we are working in a support team, do we get the chance to take time back if we have stayed late previously to get something done at work? If the answer to these questions is no, we need to speak to our managers and if we are a manager, we should consider how we can ensure our teams (and ourselves) are meeting these critical needs.

Of course, I know from over two decades of frontline work that sometimes our basic needs are the first to be neglected, as we do not recognise how important they are. I am guilty of skipping lunch and not drinking enough water, as well as just accepting that my role did not support such basic well-being needs at work. The consequence of this however was that I burnt out and left these jobs. Perhaps in hindsight if I had paid more attention to these important basic needs, I could have managed better at work in the longer term. Instead I found myself feeling more and more stressed, which led to a ‘threat response’ within myself, meaning that I could easily fall into a ‘fight, flight or freeze’ thoughts, feelings and behaviours.

In the workplace, if this happens, this means we can snap at colleagues creating issues in our relationships with others (i.e. ‘fight’), we might avoid tasks as they feel too overwhelming (i.e. ‘freeze’) or we may want to leave (i.e. ‘flight’). Our thoughts about ourselves, our colleagues and the organisation we work for, become more negative and as a result so do our feelings and behaviours. Being in a ‘threat response’ state for long periods can have a significant impact on both our psychological as well as our physical health, and is therefore far from ideal. Of course, working in the homeless sector can create situations where we are under threat (e.g. managing challenging behaviour in our clients), so we need to be able to be calm to manage these, difficult when we are already in a ‘threat response’ state due to background stresses. Consequently, these basic needs are not optional to consider, but essential — especially if we are trying to create a truly psychologically informed culture in the workplace.

As well as attending to our basic ‘survival’ needs at work, the next level in the Hierarchy of Well-being Needs’ is ‘Security’. This means that within our roles, we need to have a psychologically safe environment, free from bullying or unprofessional behaviours where everyone can come to work without fear of harassment or aggression. It is difficult enough to deal with the challenging behaviours that can occur from homeless young people to staff, without having these behaviours acted out further within staff teams. When these between staff issues do occur, it needs to be identified and addressed immediately. Perhaps the person doing the ‘bullying’ is stressed because they have not met their basic survival needs at work, and therefore is projecting their stress onto others? Perhaps the person is not aware of their behaviour, and discussions within their own supervision with a manager need to be a priority in order to give them a safe space to reflect upon and generate ways to change their behaviour and/or repair any harm with colleagues. Team reflective practice sessions can also be a space to reflect on team wide dynamic issues and help those involved to work or communicate together better in the future. By being proactive in addressing these issues, hopefully they can be ‘nipped in the bud’ and reduce the potential for formal grievances.

This level also considers the importance of having clear financial security in our jobs, such as having clear pay structures, agreed pay rises, annual leave entitlements, and ensuring that we can get our personal health needs met. I have therefore really pleased that this week has also seen the formalisation of Centrepoint’s recent cost of living allowance (COLA) pay increase, which has been carefully considered to ensure that those staff that earn least are recognised as most significantly hit by the recent high inflation and compensated accordingly. Over the past year, we also have further health benefits introduced that as per a PIE, are offering a package of support to our staff that recognises their physical and psychological well-being is important and moves us towards our aim of being ‘the employer of choice’ in the youth homeless sector.

Well-being at work is also about the next level — ‘Belonging’. These means having a sense of connection to the wider organisation. We need to believe in what our organisation is trying to achieve and we want to be a part of ensuring every homeless young person who comes to Centrepoint has the opportunity to change their story and leave with ‘a home and a job’ as well as working to #EndYouthHomelessness by 2037. This connection to the wider organisation can be a challenge when we are a national charity, spread across London, Manchester Bradford, Barnsley and Sunderland, but we do need to consider how we create connections across our geographical regions (again as per a PIE in building relationships with others!). What is less challenging perhaps (although still can be difficult with rotas, remote working etc.), is to ensure we feel connected to our individual teams. In the past few weeks, one of the themes of reflective practice in some teams is how they can create these relationships and connections with each other, which as just as important in a PIE as creating those relationships with the homeless young people we support. Perhaps we can think about what opportunities we have to create team cohesion and connections (e.g. away days, team meetings etc.) moving forward.

Creating working environments in which staff feel valued and valuable, recognised for their work and in which they have clearly defined roles and responsibilities is something all of us need to consider on both an organisational as well as individual level. I am looking forward to working further on this within the PIE informed People Strategy over the next year at the macro level, but I would also challenge each of us to consider this on the micro or individual level. Again, what can we do when we finish reading this blog, within our own teams? When was the last time we thanked a colleague for their work, or noted a “job well done”? The power of praise is one of the greatest motivators as opposed to ‘punishment’ or just noting problems or issues in shaping human behaviour and improving our psychological well-being, so let’s all look out for opportunities to praise our colleagues over the coming weeks.

Moreover, again as per a PIE, access to training and career development opportunities is key. In Centrepoint, we have now developed an expansive PIE training offer, with day face-to-face sessions, online modules and input into wider organisational training. I would encourage all Centrepoint staff reading this blog to look at our internal Learning Point system to sign up to courses that they are interested in and will support their work. If you an external blog reader, perhaps you can consider what opportunities you have or need to create in terms of PIE informed staff training and development within your organisation, and get in touch if you want to discuss ideas for these.

Moving further up the hierarchy of well-being needs is ‘Importance’, which builds further on the previous level. This encourages us to think about well-being at work influenced by factors such as how much we feel a sense of achievement and progress in our work, and whether the organisational culture respects us within our roles wherever we work. In addition, are we allowed to be independent and trusted in our work (rather than ‘micro-managed’), and again as per a PIE and the concept of ‘co-production’ (or ‘doing with, not doing to’), do we feel we are listened to at work and are involved in decision-making? I think sometimes in larger organisations, not just in the homeless sector, we can be guilty of working in silos, and not always having business empathy for other’s challenges in different parts of the organisation. I hope that we can all see how we are important pieces in the jigsaw puzzle, and without any one piece, we will not see the full picture. I often try to raise the voice in meetings of those that are not there (e.g. homeless young people, frontline staff), but whenever possible we should be looking at ways we can include those that are impacted by decisions on the decision-making process. This can not only create a positive organisational culture as all staff feel important, but also gives space for innovative ideas to solve an issue that sometimes only comes from a ‘fresh pair of eyes’ on a situation.

The final level in the hierarchy of well-being needs is ‘Self-Actualisation’. Only when all the levels below this are addressed, can we truly be an organisational culture and staff group that is performing at the highest level. If we can get to this point, we will be inspiring others to do the best they can, we know our worth and feel fulfilled in our roles, and we are highly engaged and willing to ‘go that extra mile’ that is so often needed in the homeless sector without resentment and stress upon ourselves. Of course, some days it might be easier to reach this point than on others. It is not a static state, but one that can constantly change depending on how well we and the organisation are managing the levels below.

In summary, I believe that this image, and the psychological theory that underpins it, is useful in reflecting on psychological well-being and self-care more broadly. Yes, physical exercise, social support and rest such as sleep is important outside of work, all things we can directly control and should try to factor in to our working week to prevent burnout. However, what is also important is that we take this concept of psychologically informed well-being needs into the workplace as well. Most of us spend a significant proportion of our time in work, so self-care also needs to be practiced in this setting as much as outside. Do we take a few moments away from our desks in a busy day? Do we make sure we are meeting our basic survival needs? Moreover, as an organisation are we ensuring that we are creating a psychologically informed working environment that allows our staff to reach their ‘self-actualisation’? The responsibility for psychological well-being is not only ours towards ourselves but also towards each other, and within the wider organisational culture. To neglect one area of this wider 3-fold concept of self-care, will mean that we will fall short of obtaining our optimal psychological well-being, be less motivated and engaged and as a result not achieve the best outcomes for the homeless young people we support, the reason we are all here in the first place…

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Dr Helen Miles

Consultant Clinical & Forensic Psychologist & Head of Psychologically Informed Environments (PIE) at Centrepoint @orange_madbird