7 research outputs found

    Implementing psychological formulation into complex needs homeless hostels to develop a psychologically informed environment

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    This study explored the implementation of psychological team formulation in two single-gender hostels for homeless individuals experiencing multiple complex needs. Nine hostel staff took part in two semi-structured interviews, before and after attending up to eight formulation meetings. Thematic analysis identified that staff perceived team formulation to increase their understanding of service users, led to some developments within the team, and encouraged staff to take a different approach to their work, perceiving themselves and service users more positively; however, the usefulness of formulation was restricted by the systemic limitations. Results suggest team formulation has notable benefits for staff in hostels supporting individuals with multiple complex needs

    Complex needs in homelessness practice; a review of 'new markets of vulnerability'

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    This article reviews institutional responses to adult homeless people, to argue that there is a contemporary flourishing of debates about complex needs across homelessness research and practice fields. These understand housing need as a mental and physical health issue and a care and support need, with foundations in biographical and societal events, issues and experiences, including trauma. Responses to complex needs are conceptualised as enterprising in scope; articulated as fresh, proactive, preventative and positive. The article suggests that there are a range of legislative, policy and funding drivers for these developments, from across homelessness, housing support and adult social care fields, which are distinctive to the English context. At the same time, debates about what complex needs are, and how best to respond to them, are evident in international debates about service delivery models with homeless service users in the Global Western North. ‘Complex needs’ is defined as a travelling concept, with affective qualities, which provides foundation for practice interventions, techniques and principles in different locations. The article conceptualises institutional machinations around the governance of complex needs as ‘new markets of vulnerability’. This term theorises new markets and new marketising strategies around complex needs in the context of a much larger reconfiguring of the mixed economies of welfare around markets and market mimicking devices and practices. It is argued that the intensification of activities around complex needs give insight into processes of neoliberalisation in contemporary modernized welfare ‘mixes’

    Recovery through public works: a psychodynamic perspective on change and complexity at personal, organisational & social levels

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    In this piece I reflect on my public works as a personal recovery journey enacted within and through organisational development and wider social influence, using my own process as an illustration or case study. I use concepts from (principally) business management and leadership, relational psychoanalysis, interpersonal neurobiology, complexity theory, anthropology and the recovery movement to examine the processes of personal, organisational and social change, and how they interact with each other. I argue that in each of these realms – the personal, the organisational and the social – we are talking about the interaction of complex adaptive systems, and that we can only understand and manage these processes by embracing complexity and differentiation. Simplification leads to a kind of rigidity which diminishes adaptability and resilience, and reduces creativity and the potential for integration. I argue that this has implications for practice in the fields of health and social care, which is where I work, and more widely in any field involving human social or behavioural change. I evidence and illustrate this through my own evolutionary growth, and through the innovations and developments I have initiated in the field of homelessness, health, and mental health which I am collectively calling my public works. These public works have both formed part of, and been informed by, my personal growth; for this reason, because change and growth actually take quite a long time, I have presented a timeline using examples of public works dating from 2000 to the present. I give 26 examples of public works in the text, which do not include all my publications, conference presentations, workshops etc, which are included in the appendices. The examples I give are mainly of innovations in practice, because I argue that the internal change process manifests in changed practice – this is the essence of the concept of recovery – and changed practice in turn influences the internal change process. It is the hermeneutic enactment of the physical sciences’ hypothetico-deductive model in the social arena: theory informs activity, observation of the activity evidences or amends theory, which in turn informs renewed activity. Following on from this, I argue that taking a psychodynamic conceptualisation influenced by learning from other disciplines, most notably biology, neurobiology, complexity theory and the ethos of recovery, has important implications for the development of health and social care, for us as individuals and more widely for our society as a whole. By seeing the positive value of change, differentiation and complexity, recognising that these occur within interactive relationships, and then allowing ourselves to work as positive causes without trying to control the outcomes, we can create a positive and progressive social dynamic which will of itself create the positive outcomes we would like to see. An important component of this, which I highlight, is recognising that dynamic, flexible and mutually rewarding relationships are vitally important both in the conceptualisation – the theory integrates ideas from many disciplines – and in the practice, which requires creative cooperation between multiple practitioners. Integration should not be confused with homogeneity; rather, I argue that it is more like multiple part-objects dancing together. Furthermore, I argue that this whole process does not start out there, but within: the key to beginning to achieve all of this is personal change. Personal change (recovery) is then enacted through public works

    Psychotherapy with people who smell

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    This paper stems from psychotherapy work with patients who ‘neglect personal hygiene’ in homelessness and chronic mental health settings, and consultancy to staff groups tasked with patients’ ‘social inclusion’. Psychoanalytic theory has largely eschewed exploring internal psychic states communicated by odour and, equally, the meaning of marked societal hostility towards malodorous individuals. The paper looks at historical and anthropological notions of ‘dirt’ and the construction of the ‘unwashed’ as a social category in the formation of bourgeois society. Psychoanalytic ideas of unconscious bodily and psychic communication are described. Case examples explore how troubled relations between body and mind result from early abuse/neglect, where the internal world is suffocated by trauma and ‘dread’ which cannot be contained and processed. From a psychosocial perspective, taking up a role as ‘unacceptable’ is the paradoxical condition of belonging for many members of the social whole. The paper suggests that invasive smell confronts us with our repressed knowledge of that which is ‘rotten’ in the emotional and sociopolitical environment in which ‘the unwashed’ exist. An example from organisational consultancy traces profound disturbance in institutional dynamics that occurs when the malodorous individual seeks to claim shared social resources. The author questions the prevalent view that ‘being smelly’ is an attempt to withdraw from social and psychic contact, rather than a meaningful communication which is within the scope of psychoanalytic thought to understand
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