Melissa Noel Project Manager,
Camden Kaleidoscope Project, Depaul UK.
Steve McKinlay, Regional Manager, Depaul UK.
PIE in Practice
Implementing the PIE
approach at Depaul UK
Camden Kaleidoscope
Depaul UK Camden Kaleidoscope
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High Support Accommodation for young
people with mental health and complex
needs
7 bed accommodation
Issues ranging from psychosis, self harm to
personality disorder
Five principles of PIE- “Psychologically
Informed Services for Homeless People” Feb 2012
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Physical Environment and social spaces
Managing Relationships
Psychological Framework
Staff Training and Support
Evaluation
Putting these Principles into Practice
The lens through which all staff work and plan the
physical environment
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Physical Environment
Staff Attitudes/Approach
Staff Tools
Reflective Practice
Outcomes and Evaluation
Physical Environment
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Use of colours-calming colours-greens/blues
Homely environment with art and plants
Residents involved in decoration/set up of
the garden
No directive signs in communal spaces-staff
to speak directly to residents if there are
issues or concerns
Staff Approach and Attitudes
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CBT perspective- interactions between core
beliefs, thoughts/feelings and
behavior/emotions
No labels, only descriptions/explanations of
behavior
Focus on past relationships and attachments
Staff Tools
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Chain Analysis-most commonly used
ABC chart with staff and residents
0-100 scale
Case Studies–
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TB-self harm
KM
Reflective Practice
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Reflective time in team meetings-weekly
Reflective Learning log after incidents
3X monthly reflective practice sessionsproject workers, managers, and project
manager-CAMHS provided
Very effective to monitor/discuss staff
reactions/feelings towards working with
residents
Evaluation
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Staff evaluations pre/post training, 6mo, 1yrshowing positive change in attitudes towards facilitating change
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Reflective practice 6 month evaluationsworthwhile space-logistical suggestions/whole group
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Client Surveys
Outcomes so far–
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Decrease in individuals incidents/client alerts-emergency
services
Increased engagement with external services/medication
Resident retention-KM particularly
Goal based progress/outcome star
Challenges
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Staff buy in
Slow progress
Connecting outcomes directly to PIErecording use of tools in keywork/client alerts on database
Case Study KM
Born into an unstable chaotic environment - father left before birth,
mother had children removed and placed in care. Mother had
personality disorder and was seen as incapable and this builds
on the sense of a lack of being able to take responsibility which
is behavior KM exhibits.
Before moving to CK, KM had been in care since age 10 and
recently had been evicted from all medium support
accommodations in the YPP.
Since she moved in her behaviour:
 Self-harming
 Throwing items
 Damaging room
 Verbally aggressive towards staff
 Self destructive mood/thoughts
 Outburst anger: banging, screaming, breaking things, punching
herself, talking to herself
Strategies and Outcomes
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Staff applied chain analysis and cbt to help KM identify what
triggers her behaviour, what she could have done differently
and therefore starting to change her behaviour.
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Positive reinforcement and achievement chart-highlighting and
reflecting on positive behaviour
Validating emotions but discussing choices in support/behavior
Outcomes
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Maintaining accommodation
Engaging with medication and mental health services and
diagnosis of BPD