- All staff are trained in the approach, which focuses on understanding the impact of trauma on behaviour and decisions
- The approach has been well received by young people and staff say it has helped them build better relationships
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A charity working with homeless young people in the West Midlands has spent the last decade developing a psychologically informed environment (PIE) for its staff and practitioners.
St Basil’s whole organisation approach uses psychological theories, including trauma-informed principles, to inform its practice which supports thousands of vulnerable young people across the region.
As both a charity and a housing association, St Basil’s places hundreds of young people aged 16 to 25 in its supported accommodation schemes.
Furthermore, its work with partner agencies in Birmingham, Coventry, Sandwell, Solihull, Walsall, Warwickshire, Worcestershire and Wyre Forest, means around 1,500 young people are housed annually in 33 supported accommodation schemes.
Each year, nearly 5,000 young people, who are homeless or at risk of homelessness, are supported by St Basil’s through its prevention and accommodation services as well as its employability programmes.
By using the charity’s PIE model, staff and practitioners are helped to understand the experiences of these young people, most of whom will have suffered incidents of trauma and abuse as well as mental health issues.
The approach not only provides a clear framework within which staff can operate, but it also gives them a psychological “tool kit” to help them work more effectively, explains Dr Amanda Skeate, a consultant clinical psychologist for the charity.
Having been involved with St Basil’s PIE from the start of its development in 2011, she says it is much more than a training programme for staff.
“Being a psychologically informed environment is very much an approach,” she says. “It incorporates all the principles of being a trauma-informed environment but it places an additional layer to that.”
A recent report from NPC, which highlights St Basil’s PIE model as an example of good practice, outlines five main principles for providing care in a trauma-informed way.
These include recognising and responding to trauma, providing safe environments, empowering people to support their own recovery, building empowering relationships and promoting equality of access.
Skeate says while the charity’s PIE model covers these key principles, its delivery by clinical psychologists sets it apart from other trauma-informed approaches.
“When you consider issues such as equity of access, for all of our policies, procedures and referral processes, we ask ourselves is it psychologically informed? How would a young person see that?” she explains.
“As a clinical psychologist I have that deeper level of understanding of how mental health problems develop, particularly at high levels for young people who have had a number of adverse childhood experiences,” she adds.
Skeate says adverse childhood experiences (ACEs) are taught to staff on the PIE foundation training which involves a three-day course.
“It helps people not only understand the behaviours and the mental health difficulties of children and young people who have experienced a high number of ACEs, or a degree of trauma, but it also gives them a tool kit to work with these young people,” says Skeate.
She says all staff are required to complete modules from the first day of training which ask them to think about their own response when they feel a range of emotions such as anger or anxiety.
“We look at the neuropsychology of what’s going on in the brain and why sometimes we might react in irrational or unhelpful ways.
“It’s taking that blame or criticism and helping understand how we respond and through that learning about ourselves, we can help understand our young people better,” explains Skeate.
A further aspect to operating within a psychologically informed environment requires all frontline staff and managers to take part in regular reflective practice sessions.
Supported and facilitated by Skeate, these sessions held roughly every five weeks, are considered so integral to St Basil’s PIE approach they are included in the charity’s key performance indicators.
These reflective sessions aim to help staff feel valued and supported when dealing with young people, often in extremely challenging circumstances.
“We see young people who are feeling very distressed, marginalised, discriminated against so that shows up in behaviour,” she explains. “They might shout at a member of staff who is desperately trying to help them.
“By thinking about the needs of staff and getting them to consider how they tick, what are their triggers, we are equipping them to be able to respond more effectively to the young people.”
Skeate says the PIE model is consistently informed by initiatives such as the charity’s youth voice programme, which asks young people about their needs as well as inviting feedback on how well they are being supported.
She says the developments of the PIE approach have been “incremental” since it was first launched in 2011.
“We started off with three days’ training which we have since improved and through staff feedback we’ve been able to understand more about the outcomes and challenges that we have with young people,” she says.
The onset of the coronavirus crisis last year forced Skeate and her colleagues to rethink how they could continue to deliver their training and reflective practice sessions.
Skeate says a successful transition online is continuing to support existing as well as new members of staff (see below).
With the pandemic set to increase the number of vulnerable young people, Skeate expects PIE to become a vital tool in helping those who struggle get back on track.
IMPACT
The charity regularly uses a young persons’ survey to evaluate the impact of its PIE approach.
Skeate explains that while the questions asked may seem pedestrian they “map” onto the PIE training and how staff understand its key aspects.
“For example, young people responding to whether or not they feel welcome is important because through the training, we teach listening and from that comes validation.
“More than 90 per cent of young people rated that they ‘agreed’ or ‘strongly agreed’ to feeling welcome.
“Given the difficulties of young people, some of whom might have been excluded from home, that is actually quite a high result given their needs and experiences,” she adds.
Similarly, the PIE approach places great emphasis on the quality of relationships with young people.
“Being able to develop that quite quickly, and in a difficult environment, can make a difference between a young person opening up and accessing services. Young people rate us quite highly on that,” says Skeate.
Such is the success of St Basil’s PIE training that it also delivers sessions to other organisations that work with people with complex needs. These include local authorities, Birmingham Children’s Trust as well as schools.
“We’ve got a PIE for schools as well that we help deliver training and reflective practice,” says Skeate.
“We know that if young people stay in education, have clear pathways to college or apprenticeships, they are far less likely to become homeless.”
‘TRAUMA-INFORMED APPROACH HELPED ME BETTER UNDERSTAND YOUNG PEOPLE’S NEEDS’
Conor O’Neill, who joined St Basil’s in July as a progression coach, was one of the new members of staff to complete their PIE training virtually.
O’Neill says he enjoyed the online sessions particularly as they were delivered by experienced professionals such as Dr Amanda Skeate, consultant clinical psychologist.
“It’s really helped me in day-to-day conversations, not just with young people but with my colleagues as well and the way I approach work before I even get in the door,” he says.
As a progression coach, O’Neill supports young people to complete life skills programmes offered by St Basil’s as well helping them with practical issues such as college or job applications.
Together with his colleagues, he is also responsible for dealing with mental health issues and signposting young people to the right support services.
“Some people, especially the older generation or perhaps those without children, might have different theories of how to approach these young people – even myself before I started the job.
“But PIE makes you more understanding of what some of the residents have gone through.
“If you are having a difficult conversation you might just think that person is just being a teen, but what you might not realise is the psychological aspect of abuse they have gone through in the past,” says O’Neill.
Dealing with a wide range of issues from mental health to relationship problems to immigration, he says the PIE training has enabled him to build better relationships with the young people he supports on a daily basis.
“It definitely helps and in the long term it boosts that relationship that you have with young people and the results that you get,” he adds.
On a personal level, O’Neill says he has also benefited from taking part in reflective practice sessions.
He says they have helped him to cope better during more stressful periods at work.
“Some weeks are fine but other times it feels like everything can go wrong. Nobody wants to be the first person to open up about something difficult but if they do then everyone feels more validated,” he says.
O’Neill says a PIE approach is vital in an organisation such as St Basil’s that supports some of the most vulnerable young people.
“Some people think PIE is just common sense but it’s important otherwise we would forget who we are dealing with.
“We do get bumps in the road, but 90 per cent of the time because we are subconsciously thinking about PIE, things end up working out well,” he says.
Read more in CYP Now's special report on trauma-informed practice
