Dr Ray Middleton is the Workforce Development Lead for the National Lottery Community Fund’s Fulfilling Lives programme in Newcastle and Gateshead (FLNG). With a special interest in trauma-informed care, Ray is piloting a programme to develop Psychologically Informed Environments (PIE) in frontline services combining an innovative ‘Open Dialogue’ approach to mental health with PIE using the ‘Ladder4Life’ framework he developed.
A Psychologically Informed Environment (PIE) is a space which considers ‘the psychological make up – the thinking, emotions, personalities and past experience – of its participants in the way that it operates’ (Johnson et al., 2012).
FLNG have been enthusiastic promoters of PIE since our programme began in 2014. Evidence from our initial PIE pilots in 2016 (described in this report) highlighted the need for good quality training for PIE ‘Leads’ and the importance of senior level support within organisations which encouraged us to embark on the next ambitious phase of our PIE journey and in this blog I talk about how we have developed and shared our approach to PIE self-assessment since then.
Our training offer
Workforce development is one of our programme’s key strands of work and we offer a range of free training to support services in our region to work better with people experiencing multiple and complex needs. This approach has attracted international attention and featured in a book on innovation in the sector when we were invited to write a chapter for Cross Cultural Dialogues on Homelessness.
Following on from our 2016 pilots and in the hope of encouraging other local services to adopt PIE, we developed a ‘PIE Lead’ training programme that equips a member of staff to go back to their own service and create a PIE (version 2.0) baseline self-assessment report describing their current position in terms of PIE, including plans to progress. Information on the PIE 2.0 can be found here.
Currently, we have trained staff from 46 different services as ‘PIE Leads’ in five cohorts over the last 15 months. The sectors trained included our four key areas of mental health, housing, probation and substance misuse.
PIE self-assessment process
Like any successful journey, it helps to know where you are starting out from and we have found Pizazz, the PIE self-assessment framework designed by Robin Johnson (www.pielink.net), to be a useful, user-friendly tool to help any service get started on their PIE journey. An explanation of the self-assessment framework Pizazz can be found here.
The self-assessment process is a collaborative process where the PIE Lead gathers the views of their team to self-assess their service through a reflective dialogue about what helps and hinders progress. They then agree an action plan about how to improve in each PIE area.
Being trained in PIE self-assessment is a bit like learning to drive; it helps to read the theory and get some lessons but at some point you have to jump in, get behind the wheel of the car and just drive! We find that asking your team what they think and writing up your initial baseline PIE self-assessment is a bit like driving a car for the first time with that emotional mix of excitement about what you might discover and understandable anxiety about ‘doing it right’.
However, once you have built capacity through training to self-assess a service using the PIE framework you can repeat it at a later date to measure progress against plans in the five PIE areas of:
- Psychological awareness
- Staff training and support
- Learning and enquiry
- Spaces of opportunity
- The ‘Three Rs’ (roles, rules and responsiveness).
PIE allows adding sub-topics under each of these initial areas, so we have also added ‘Reflective practice’ under the ‘Learning and enquiry’ area, asking the same PIE questions about current practice, what helps and hinders progress and what plans to progress exist.
PIE in practice
We have been involved in a pilot of some new PIE software called iAbacus which is a useful tool for producing service specific PIE reports in a visually appealing format – I’ll talk more about this pilot in my next blog but you can see an example of a Pizazz PIE self-assessment for a typical service written up on the iAbacus here.
The first cohort of our PIE Lead training course has now completed a second PIE self-assessment to measure progress, as what has value is the work actually put into improving in each area and not just getting the initial measure of where a service is at. This follow-up assessment identified modest improvements in all areas once the Pizazz framework was being used as a repeated measure:
By working with services like this we are gaining a greater insight into PIE in practice and factors which help and hinder progress. In my next blog I’ll talk about our learning points so far and how we can develop on these as we move forward. In the meantime, if you’d like to find out more about the PIE training Fulfilling Lives Newcastle Gateshead offers or have any questions about the approach, please visit the Workforce Development area of our website or drop me an email at Ray.Middleton@fulfillinglives-ng.org.uk.