Literature Review
Traditional service provision and psychotherapies may not meet the complex needs of people experiencing homelessness. Psychologically Informed Environments (PIEs) is an approach which attempts to embed psychological thinking and practice into services for people experiencing homelessness. A qualitative evidence synthesis was conducted to explore the experiences of staff and service users in delivering or receiving support under a PIE. Three electronic databases were searched, and ten studies were included. Data was analysed and three themes were identified. Participants described PIEs providing a focus on relationship, relational and physical safety, and promoting understanding. This was supported by spaces for staff to pause and think, changes in staff behaviour, and an appreciation of the trauma experienced by the homeless community. However, there were barriers such as difficulties in the wider system, staff ambivalence, and a lack of clear outcomes for service users. Further research is needed to explore the impact of PIEs for those at the intersection of homelessness and other marginalised identities, and how outcomes of PIEs are collected and reported.
Empirical Study
Previous research has suggested that PIEs are experienced as helpful by the staff implementing them, and by some servicer users’ receiving support within them. This study explored what makes a PIE helpful, from the perspective of staff and service users. Sixteen staff and service users from a national homelessness charity took part in semi-structured interviews. The interviews were analysed, and four themes were identified. Participants described how a focus on practical support enabled them to stay engaged with the service, and supported staff to feel useful in their work. Acknowledging and addressing the power imbalance in relationships, by giving service users choice, treating them with respect and honesty, and fighting for their needs in the wider system, was seen as an important way that this PIE supported service users. Getting to know one another as people, being able to spend time building a trusting relationship, feeling understood, and feeling genuinely caring and cared for, as well as staff sharing some of themselves, and flexibility were important in having helpful experiences within the service. Fewer barriers to this approach were found than anticipated. This might be due to the fact that people who had chosen to disengage from the PIE were not interviewed. Future research would benefit from developing an understanding of what has been unhelpful about engaging with a PIE. This study provides support for the ongoing implementation of PIEs, but more attention might need to be given to the practical support provided and thinking about how the power imbalance is addressed.
