PIEs in clinical work

The concept of a PIE has taken root most quickly in the homelessness sector.  But as the briefing paper Is a PIE just about homelessness? points out, that may simply be because there was most need for such thinking there, where there had been an enormous amount of innovative practice that has not yet found a name.

But there is nothing in the basic ideas of a PIE - neither in the original 'classic' account, nor in the revised 'PIEs 2.0' - that is specific to homelessness. The issues that arise in trying to develop whole environments, arise with many client groups; and the PIEs formula arose originally from a long tradition of attempts to craft health and social care and other such settings.

Much of this past history is described in several articles and papers here - especially in relation to milieu therapy, therapeutic communities and enabling environments. Even now we find some striking parallels between the developments we had seen in homelessness services, especially in the UK, with emerging clinical practice in other areas such as the Department of Health's Personality Disorder pilots.

But in recent years we have seen these ideas, which branched off from health and social care in order to develop new directions,  'coming home' and being consciously re-introduced in clinical settings. One key theme and commonality, as we see from the work of adult mental health wards in Bristol,  is the value of introducing reflective practice, as commended in the PIEs 2.0 formula in particular, which placed RF at the heart of all development.

Similarly, in the work of Jay Levy to describe outreach work via his "Pretreatment approach', there is nothing in there that is unique to homelessness. The term itself came originally, he tells us, from work with substance abuse, and he saw the relevance of this framework of ideas for the homelessness outreach field where he works.

Now, in John Conolly's  description of "Pretreatment therapy", we see the same ideas, more fully developed, being re-incorporated into clinical settings.

Psychiatric care environments : HERE

Recommended reading 1: a long tradition

The Handy Guide (2013)

That other bloke with MH  housing

Tweed Annexe