Jean Templeton St Basils

THE VISION… To see adequate provision made in homelessness services facilitating effective treatment for psychological issues within homelessness To ensure that staff are adequately equipped to effectively deal with complex problems 2008 Rough Sleepers Strategy

 A number of terms used interchangeably  Complex Trauma  Complex PTSD  Type II Trauma  Disorders of Extreme Stress Not Otherwise Specified (DESNOS; DSM-IV (APA, 1999))  Describes observations of:  Alterations in emotion and impulse regulation  Dissociation  Changes in self-perception  Difficulties relating to others  Somatisation  Alterations in belief systems held by the individual

 Interpersonal issues  Attachment  Emotion regulation  Negative beliefs about self and others  Impulsivity  Other trauma experiences  Flashbacks, rumination  Complicated by natural processes in adolescence  Identity formation (beliefs, belonging)  Emotion regulation  ‘Separation ’

PSYCHOLOGICAL, EMOTIONAL AND BEHAVIOURAL PATHWAY TO REPEAT HOMELESSNESS Childhood abuse / neglect Emotion dysregulation Experiential avoidance Maladaptive coping style (externalising) Rumination Shame, guilt Drug and alcohol use Asocial and antisocial behaviour Lack of social and practical functioning skills Repeat tenancy breakdown Triggers : Release from prison Relationship breakdown Discharge from armed services Loss of tenancy Modelling Attachment problems

 Whole environment operates according to an agreed psychological framework  Keywork sessions  Use of reflective practice  Residents’ meetings  Peer mentors  Environment may also reflect psychological thinking  Residents’ input into surroundings  Residents’ use of facilities  Effects are monitored (measured)  Meaningful

 Need to be clear about what it is we expect to change For clients For staff For service  Clarity about how we expect to facilitate change Emotional change Behavioural change Cognitive change Change in attachment experience

Improve positive outcomes for young people, build resilience and capability and enable them to move on and sustain their independence in an increasingly challenging environment Ensure staff have skills, attitudes, behaviours and resilience to cope and support positive outcomes for young people

1. Core training in psychological skills for all staff 2. Specialist training for some 3. Development of evaluation framework and infrastructure and review and analyse data over 3 year period 4. Reflective Practice groups in collaboration with NHS partners 5. Review tools and working methods to ensure they support an approach consistent with Psychologically informed environment

Professional Standards Personal Effectiveness Organisational Effectiveness - Reflective Practice Outcome-Led Approaches - Payment by Results Young People’s Voice Co-Production - Personalisation

 Dr Nick Maguire, Senior Clinical Psychologist, Southampton University  Birmingham and Solihull Mental Health Foundation Trust  Department of Communities and Local Government  Pro Bono Economics  London Housing Foundation  University of Birmingham – Mental Health Study positive outcomes for young people

 Reflective practice in consistent groups is absolutely critical  Embed techniques and approach in all your work  Part of induction and regular refresh Year 1 KPIs:  13% reduction in serious incidents  50% reduction in NTQs for behavioural issues  19% reduction in unplanned departures  26% reduction in sickness absence  7% reduction in grievance and disciplinary actions

PIE at St Basils Youth Involvement Review Equality and Diversity Action Plan Training and L& D Programme Reflective Practice Mental Health First Aid Programme 3 year monitoring and review Lifeskills programme Asset Management Strategy Outcomes Star Integrated Approach to LSW

DCLG – Psychologically Informed Services for Homeless People- Good Practice Guide February