Developing best practice in psychologically informed environments

Abstract

Paper type: Research paper PurposeThe purpose of this paper is to extend our understanding of the issues facing those who experience multiple moves around homelessness projects. It considers these issues and how they relate to best practice, informing the delivery of Psychologically Informed Environments. Design/methodology/approachA qualitative design was employed, with interviews undertaken with men currently residing in hostels for those with additional needs. These men had already experienced multiple moves within the hostel system. Interpretative phenomenological analysis was used to analyse the data. FindingsMain themes consider issues and challenges associated with hope and moving forward; help and the conditional or temporal nature of this; identity and stigma; and intimacy and relationships. Clinical implications of these findings are discussed. Research limitations or implicationsImplications include best practice for future planning with service users, the relational nature of hope, how best to manage endings and practical guidance for service developments in these settings. OriginalityThese findings further our understanding of the challenges faced by service users with complex needs and how best to address them. They build on PIE guidance, offering tangible advice for practice.

Building connection against the odds: project workers relationships with people experiencing homelessness

“…The results of this study corroborate the frequently expressed need for teams and systems supporting PEH to work in a psychologically informed manner, considering the emotional needs of both residents and staff (Johnson and Haigh, 2010; Phipps et al , 2017; Westaway et al , 2017). The clinical implications from the current study will now be considered within four of the PIE principle: developing psychological awareness, staff training and support, a focus on learning and enquiry and rules, roles and responsiveness (Johnson, 2018), presented in Table I.…”

“…The conditionality of housing and support left PEH feeling disillusioned and hesitant to seek help (Jost et al , 2014), preventing PEH from trusting and engaging with services and workers (Zerger et al , 2014). Internal conflicts were experienced by PEH simultaneously desiring meaningful relationships with workers and fearing rejection (Westaway et al , 2017). However, valued relationships were built on trust, flexibility and acts of kindness and formed the basis for PEH opening up and engaging with services (Jost et al , 2014; Oudshoorn et al , 2013; Stevenson, 2014).…”

Change readiness in individuals experiencing homelessness and multiple complex needs

“…Watson et al, 2019). Through staff promoting hope, individuals are encouraged to take control of their lives (Westaway, 2017). Weingarten's (2010) concept of "reasonable hope" supports this notion, referring again to the relational nature of change, and explicating "scaffolding" as conceptualised by Vygotsky (1987), to support the development of change in achievable steps.…”

“…Deductive coding involved using pre-existing psychological theory to guide analysis of the meaning of data while caution was taken not to lose the connection between psychological interpretations and the participants' own words (Braun and Clarke, 2006). This part of the analysis was informed by existing literature focussing on: the role of compassion in support for the homeless (Limebury and Shea, 2015), care versus control in homeless professionals (Renedo, 2014), relational hope (Westaway, 2017), building connection between service users and workers (Watson et al, 2019), research on how change is measured (Bandura, 1998;Littell and Girvin, 2002), the influence of multiple complex needs (Everitt and Kaur, 2019) and wider socio-environmental influences (Eriksson et al, 2018;Nooe and Patterson, 2010). The next stage of the analytical process consisted of drawing together the inductive and deductive codes, exploring the conceptual similarities between both, to cluster and construct the definitive themes.…”

‘They already operated like it was a crisis, because it always has been a crisis’: a qualitative exploration of the response of one homeless service in Scotland to the COVID-19 pandemic

“…PIEs have gained increasing attention in the homelessness sector, and the approach comes from a recognition that people who are homeless have commonly experienced high levels of trauma and deep social exclusion [ 41 , 44 ]. PIEs advocate for the emotional and psychological needs of the client group to take priority, through low threshold/nonpunitive engagement [ 45 ]; adaptations to physical spaces [ 41 , 45 ]; the creation of organisational cultures that are reflexive and centred around psychological needs [ 46 ]; valuing relationships with clients [ 46 ]; and fostering a sense of shared ownership [ 47 ]. Services informed by PIEs have been shown to improve client outcomes in several ways, including enhanced mental health and wellbeing and reduced involvement with criminal justice and emergency services, and facilitating engagement with health and other care services [ 48 – 50 ].…”