A PIE of pathways

Please note; we are in the midst of a thorough re-construction of these pages. For the moment, there may be some duplication of material from elsewhere; and probably some broken links. Bear with us. Its a lot to cover......

A PIE of pathways

What we have found, in 20 years of on-going dialogue with the more progressive of services for people with more complex needs services, is that making and working with relationships is central (HERE).

We now see this as one of the fundamentals of being a PIE at all, and something that runs through all aspects of the work, and at all levels (HERE). We find this in developing theory, as well as in developing practice.

Yet making constructive relationships is not just about working with service users, central though that may be (HERE). It is also important to have good working relations within each service; and between services, that must work together, to meet complex needs.


Managing for continuity

Psychotherapists have argued more many years that attachment is a basic human need, and disruption of attachment leads to many forms of dysfunctional responses (HERE - link needed ). More recently, much new thinking on early trauma also suggests the importance of rebuilding trust, and valuing the continuity of supportive relationships (HERE).

In practice, though, this is not how services have typically been developed, and funded, in the recent past.  Working with relationships may then mean tackling, bridging and transcending the barriers between specific services (see: Gaps and Barriers : HERE).

Sometimes this may need to challenge the ways that services have been provided, in the past, both at local level, where relationships between agencies may need remedial work, and at national and policy maker level, where dsyfunctional ideas of public service delivery may still hold sway (HERE) .

Complex and entrenched needs require both longer timescales and subtler and more multi-dimensions outcomes. It is not simply the proponents of Housing First that question the constant 'staircase' (or 'pass-the-parcel') approach that has characterised much thinking on service provision in the past. Measures of success and 'value for money' that might be quite workable for simple interventions can all too easily ignore the real nature of work with the more marginalised and disengaged. Worse, they can end up blaming the individual as ‘hard to engage’; or the services working with them as ‘failing to deliver’.

(This is not to say, of course,  that short term services themselves cannot be psychologically astute; on the contrary, short term and initial engagement services play a crucial role in initial engagement, paving the way for others to build on a constructive first encounter. For more on this, see:  Short term services as PIEs?: HERE).

But it does suggest that for PIEs to develop to their full potential, we need not just the individual services as PIEs, but the whole network or pathway needs to be more coherent, more person-centred, more psychologically informed.


An Abacus for whole systems work?

The more systemic features of the PIE approach, and the Pizazz, aim at providing a mechanism, a tool for operationalising this new vision at system level.

For commissioners and other funders keen to see a 'whole systems' approach, and deeper system change, the PIE Abacus - still experimental -  may now offer a tool for obtaining that local overview of gaps and hindrances to be addressed (HERE), in a needs ands strengths audit.

Using the PIE Abacus, the views of services' staff can now also be complemented and strengthened with service user input in these local assessments (HERE).

This more systemic approach to assessment may help to operationalise in practice the recommendations of the initiatives such as Lankelly Chase (HERE), Collaborate and Human Learning Systems (HERE), Enabling Help (HERE), and the Alliance for Useful Evidence (HERE).








Further background reading/listening/viewing

PIElink pages

Whole systems as PIEs ; HERE

A PIE of pathways : HERE

'Joined up thinking' : HERE

Gaps and Barriers : HERE

Rigidity and system change: HERE

A single framework : HERE

Spaces of opportunity 101 : HERE

Can commissioning help to encourage PIEs? : HERE


A selection of like-minded agencies & colleagues

Beyond Outcomes (Enabling Help) :  HERE

The New System Alliance : HERE

Human Learning Systems : HERE

Fulfilling Lives : HERE

Collaborate CIC : HERE

Lankelly Chase : HERE


What psychology?:  HERE

Is the PIE evolving?:  HERE

Navigators and "system brokers' : HERE

Library items

Economic theories relevant :  HERE

Three theories of homelessness, and the psychology needed :  HERE

Embracing the mess to do what's best :  HERE

A very brief history of PIEs :  HERE

Behaving like a system:  HERE