Three schools of scepticism, plus one simple mistake to make

It's hard - and not necessarily even helpful - to categorise opinions. But it may be safe enough to say that there are at least three main schools of scepticism about the value of PIEs, with some justification; and at least one outright dismissal, without any.

 

Scepticism school No 1 : "it's just another fad, more buzz words"

Sadly this is often true. It is all too possible to decide to call a service a PIE, with only lip service, and little real understanding. Typically this is done quite opportunistically, just because commissioners may have stipulated - unhelpfully - that the services they fund should 'be' a PIE.

At worst, a cluster of quite superficial 'add ons' may be introduced, as a tick box exercise. Or imposed from outside the team or service, at the behest of 'the Top Brass', 'implementing' the PIE. The central process of self-assessrnent and self development is then sidelined.

It is also common to find services, when they finally get to hear what this is really about, saying: 'well, now we realise we were doing some of this all along'. It is important to value those voices that say: this is nothing new.  The PIE framework is just a way to see things more clearly; and then go on ask: so now what might you do?

 

Scepticism school No 2 : "it's just too much to ask. We don't have time for this."

This is another valid challenge. The enthusiasm for PIEs has ramped up expectations as to what services will do, without necessarily any real change in the resources, and especially in the wages of staff.

The only real answer to this challenge is that, done properly, the PE seems to be a great way to appreciate, to motivate, and to keep, your staff. If its not as good as paying them well, it may be the least you can do. But the evidence - such as it is - does suggest that introducing some PIEs practice may also reduce challenging behaviour amongst service users.

 

Scepticism school No 3 : "it's just not evidence based" or "Where is the data, so we be sure this is effective?"

It is largely true that the PIE approach is not evidence-based, but only in a rather narrow sense of the word 'evidence'. The PIE approach arose out of some fifty years of experimentation in social psychiatry, and almost as a long a time - certainly thirty years - in homelessness work.

But this is not laboratory research, consistent and replicable, with random controlled trials and clear quantifiable results. This world is not like that. The evidence is what we learn from experience. To compare the PIE approach with, for example, CBT, or Valium, is simply to misunderstand the nature of the PIE as a framework.

It is not a new set of things to do, which must be evaluated, individually or collectively. It is a new way to see what you do do, in order to help you to think about what you could do. Like any tool, its only as effective as the way its used.

 

Scepticism school No 4 : 'We just want to develop Housing First, so we won't need PIEs'

It is true that the PIE framework can be used in hostels -  the kind of transient and even 'conditional' accommodation that is seen as unnecessary and even negative by some proponents of Housing First. But to suggest that we don't need hostels so we don't need PIEs is simply a misunderstanding (technically what philosophers have called 'a category error').

The PIE approach is not an alternative model to Housing First; it is a way of looking at ALL services, including Housing First, to see what we need to do.

When Housing First really works, it is because these services work with all the issues that may arise in homelessness and complex needs. The issues that are too flexible and contextual to be included in the tighter specification of the Housing First model are those we try to explore, via the PIEs framework.

 

 

Further background reading/listening/viewing

It's just a fad/buzz words

The Inner Game of PIE : HERE

PIEs accreditation? : HERE

Ladder 4 Life (Ray Middleton's PIEs training: this excerpt an interview with Robin Johnson) : HERE

 

We just don't have time for this

"A response from the sector" (Vic Rayner on her reservations) : HERE

How far do you want to go? : HERE

Baby steps (on peer review) : HERE

The coffee break Pizazz : HERE

 

It's not evidence-based

Embracing the mess ( on Complexity friendly commissioning) : HERE 

Conducting research in a person-centred way : HERE

The importance of relationships in knowledge translation and implementation  (CHI webinar discussion) : HERE

Making Sense of Complexity - an introduction to Cynefin (You Tube video) : HERE

PIEs and 'exclusion-informed' research : HERE

PIEs evaluation : HERE

PiE Abacus as research tool : HERE

 

We just want to develop Housing First

Developing Housing First - the 'non-negotiables'  : HERE

Oil and water? Housing First : HERE

Housing First and PIEs in the US and the UK : HERE

The characteristics of successful supported housing - single site Housing First in Finland : HERE